DR. JUSTIN B. MCGOLDRICK (NPI# 1114960101) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114960101 |
| Entity Type | Individual |
| Full Name | DR. JUSTIN B. MCGOLDRICK |
| Credential | M.D. |
| Practice Address |
110 Hospital Dr Jefferson City TN 37760-5281 |
| Mailing Address |
Po Box 634706 Cincinnati OH 45263-0001 |
| Practice Telephone | 8654712500 |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2007-11-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 35270 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | BLUE CROSS | 4014592 | 01 |
| TN | RAILROAD MEDICARE | P00189111 | 01 |
| TN | 3865960 | 05 | |
| TN | BLUE CROSS | 4150060 | 01 |
| TN | 3865961 | 05 |
| Street Address |
110 HOSPITAL DR |
| City | JEFFERSON CITY |
| State | TN |
| Zip Code | 37760-5281 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952724403 | Russell Walters | Physician Assistant | 110 Hospital Dr, Jefferson City, TN 37760-5281 | 2014-02-03 |
| 1619302858 | Tabetha Ann Sparks | Nurse Practitioner | 110 Hospital Dr, Jefferson City, TN 37760-5281 | 2013-09-06 |
| 1912249814 | Joshua Porter | Emergency Medicine | 110 Hospital Dr, Jefferson City, TN 37760-5281 | 2013-03-19 |
| 1205152105 | Richard Baird | Emergency Medicine | 110 Hospital Dr, Jefferson City, TN 37760-5281 | 2010-04-16 |
| 1891022026 | Nancy Samsel Walker | Registered Nurse | 110 Hospital Dr, Jefferson City, TN 37760-5281 | 2009-11-09 |
| 1306036926 | Ashlea Brooke Daniel | Nurse Practitioner | 110 Hospital Dr, Jefferson City, TN 37760-5281 | 2007-07-30 |
| 1831247519 | Tennessee Cancer Specialists Pllc | Internal Medicine | 110 Hospital Dr, St Mary's Jefferson Memorial Hospital, Jefferson City, TN 37760-5281 | 2007-01-08 |
| 1760530927 | Tennessee Cancer Specialists, Pllc | Internal Medicine | 110 Hospital Dr, Suite G50, Jefferson City, TN 37760-5281 | 2007-01-06 |
| 1700981271 | Nathan Roger Gilbert | Emergency Medicine | 110 Hospital Dr, Jefferson City, TN 37760-5281 | 2006-09-13 |
| 1053354068 | John W. Burckle | Physician Assistant | 110 Hospital Dr, Jefferson City, TN 37760-5281 | 2006-06-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699235929 | Emmley L Cole | Nurse Practitioner | 277 E W Broadway Blvd, Jefferson, TN 37760 | 2019-03-22 |
| 1275044877 | Cindy Anderson | Nurse Practitioner | 277 E Broadway Blvd, Jefferson City, TN 37760 | 2017-10-23 |
| 1801259940 | Mcfarland Group, Inc. | Durable Medical Equipment & Medical Supplies | 665 E Broadway Blvd, Jefferson City, TN 37760 | 2016-04-04 |
| 1124422266 | Penny Williams-cordeiro | Nurse Practitioner | 1901 Brookside Drive, Suite 105, Kingsport, TN 37760 | 2014-10-17 |
| 1215363841 | Lindsey Ann Clyde | Physician Assistant | 120 Hospital Dr Ste 130, Jefferson City, TN 37760 | 2013-09-14 |
| 1679849814 | Allison Renee Farris | Surgery | 120 Hospital Dr Ste G20, Jefferson City, TN 37760 | 2012-03-31 |
| 1245562891 | Steven Jarvis Monroe | Dentist | 156 W. Broadway Blvd., Jefferson City, TN 37760 | 2010-02-08 |
| 1952560625 | Summit Medical Group,pllc | Internal Medicine | 380 W Broadway Blvd, Jefferson City, TN 37760 | 2008-06-06 |
| 1780756189 | Steven J Monroe Dds PC | Dentist | 156 W Broadway Blvd, Jefferson City, TN 37760 | 2006-11-14 |
| 1720188600 | Dennis U Spjut | Psychologist | 732 E Jefferson St, Dennis Spjut Phd, Jefferson City, TN 37760 | 2006-09-22 |
| Find all providers in zip 37760 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154417178 | Edwin Dean Breshears | Emergency Medicine | 3308 West Edgewood, Suite B, Jefferson City, MO 65109-6891 | 2006-10-05 |
| 1851484349 | Vickie Jean Park | Emergency Medicine | 100 St. Mary's Medical Plaza, Jefferson City, MO 65101 | 2006-10-02 |
| 1467465799 | Charles Wayne Judy | Emergency Medicine | 100 St Marys Health Plaza, Jefferson City, MO 65101 | 2006-08-15 |
| 1255340113 | William Donald Musick | Emergency Medicine | 100 St. Mary's Plaza, Jefferson City, MO 65201 | 2006-08-07 |
| 1992786693 | Michael D. Wilson | Emergency Medicine | 1036 Satinwood Ct, Jefferson City, MO 65109-1809 | 2005-11-09 |
| 1477548352 | Thomas B Nittler | Emergency Medicine | 100 Saint Marys Plz, Jefferson City, MO 65101-1602 | 2005-09-15 |
| 1821531625 | Meadow Spring Primary Care | Emergency Medicine | 1526 Meadow Spring Dr, Jefferson City, TN 37760 | 2016-11-28 |
| 1174979520 | Jefferson City Medical Group, PC | Emergency Medicine | 1735 Elm Court, Jefferson City, MO 65101 | 2016-05-04 |
| 1346655636 | Jared Emery | Emergency Medicine | 1125 Madison St, Jefferson City, MO 65101-5227 | 2014-06-25 |
| 1912249814 | Joshua Porter | Emergency Medicine | 110 Hospital Dr, Jefferson City, TN 37760-5281 | 2013-03-19 |
| Find all providers in JEFFERSON CITY | ||||
| City | JEFFERSON CITY |
| Zip Code | 37760 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.