Individual provider Active NPI

Dana Goble

  • Physical Therapy Assistant
  • Cameron, MO
National Provider Identifier
1891183570
Registry record updated Jan 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2005032629 Issued in MO
Practice address
801 Euclid Ave
Cameron, MO 64429-2003
Phone
(816) 632-7254
NPI assigned
Jan 2, 2015
Last updated
Jan 2, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2005032629 MO Primary

Addresses

Primary practice location

801 Euclid Ave
Cameron, MO 64429-2003

Mailing address

1090 SE State Route Ee
Weatherby, MO 64497-9177
Phone (816) 244-2766

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2005032629MOMDPhysical Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1420156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420156800000",
    "number": "1891183570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 SE STATE ROUTE EE",
            "city": "WEATHERBY",
            "state": "MO",
            "postal_code": "644979177",
            "telephone_number": "816-244-2766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 EUCLID AVE",
            "city": "CAMERON",
            "state": "MO",
            "postal_code": "644292003",
            "telephone_number": "816-632-7254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOBLE",
        "first_name": "DANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-02",
        "last_updated": "2015-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "2005032629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cameron, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.