DR. CLIVE ANTHONY GOULBOURNE MD
NPI 1083024970
Internal Medicine - Cardiovascular Disease in Springfield, MO

Active since May 01, 2014PECOS EnrolledAccepts Medicare Assignment
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804(417) 820-3911 Get Directions Write a Review

NPPES record last updated: December 1, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Dec 1, 2022, Jun 8, 2021 (2 updates tracked since 2021).

About Dr. Clive Anthony Goulbourne Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. CLIVE ANTHONY GOULBOURNE MD (NPI 1083024970) is an individual cardiovascular disease provider in Springfield, Missouri, licensed in Missouri (2022040707) and active in the NPI registry since May 2014. He is enrolled in Medicare PECOS, is affiliated with Mercy Hospital Joplin, and maintains a secondary practice location in Brooklyn.

NPPES Registry Identity

NPI1083024970
Entity TypeIndividualMale
Primary Taxonomy207RC0000X
Provider Legal NameDR. CLIVE ANTHONY GOULBOURNECredential: MD
Location Address1235 E CHEROKEE STSpringfield, MO 65804-2203
Mailing Address1235 E Cherokee StSpringfield, MO 65804-2203 · (417) 820-3911
Sole ProprietorNo
Medical School CMSOtherGraduated 2009
Enumeration DateMay 1, 2014
Last NPPES UpdateDecember 1, 20222 updates tracked since enumeration
NPPES CertifiedDecember 1, 2022
NPI 1083024970 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
Licenses Licensed in MO · 2022040707 Licensed in GA · 87980
Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

1235 E CHEROKEE ST, Springfield, MO 65804

Secondary Practice Location 1

Location 1450 Clarkson Ave, Box 1262Brooklyn, NY 11203-2012 · Phone (718) 270-8867

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Clive Anthony Goulbourne Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9032451976
PECOS Enrollment IDI20221205001317
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 24

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306
This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.
640 services633 patients
Heart muscle strain imaging 93356
Heart muscle strain imaging is a non-invasive test that uses sound waves to create pictures of your heart. It helps doctors evaluate how well your heart muscle is working and detect any damage or disease. This can aid in diagnosing heart conditions and guiding treatment plans.
188 services187 patients
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician 93018
An exercise or drug-induced heart stress test with ECG is a procedure to assess how your heart functions under stress. It can involve exercising or medication to make your heart work harder while an ECG records its activity. A physician reviews the results.
143 services143 patients
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician 93016
An exercise or drug-induced heart stress test with ECG involves monitoring your heart's activity while it's under stress, either from exercise or medication. A doctor supervises the entire procedure to ensure safety and accuracy in results. This test helps detect heart problems.
131 services131 patients
Nuclear medicine studies of heart muscle at rest and with stress and spect 78452
Nuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.
128 services128 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
77 services68 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mercy Hospital Joplin

Acute Care Hospitals · Joplin, MO
1/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number260001
Location100 Mercy WayJoplin, MO 64804 · Jasper County
Emergency services Birthing friendly

Mercy Hospital Lebanon

Acute Care Hospitals · Lebanon, MO
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number260059
Location100 Hospital DriveLebanon, MO 65536 · Laclede County
Emergency services Birthing friendly

Mercy Hospital Springfield

Acute Care Hospitals · Springfield, MO
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260065
Location1235 E CherokeeSpringfield, MO 65804 · Greene County
Emergency services Birthing friendly

Mercy Hospital Aurora

Critical Access Hospitals · Aurora, MO
OwnershipVoluntary non-profit - Church
CMS Certification Number261316
Location500 Porter AvenueAurora, MO 65605 · Lawrence County
Emergency services Birthing friendly

Mercy St Francis Hospital

Critical Access Hospitals · Mountain View, MO
OwnershipVoluntary non-profit - Private
CMS Certification Number261335
Location100 West Highway 60, Po Box 82Mountain View, MO 65548 · Howell County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 65804 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$121.96 typical visit price
range $52.28 – $161.24
Typical copayment $30.49 (range $13.07 – $40.31)
Most-billed visit code 99204
Established Patient
$65.71 typical visit price
range $16.30 – $131.05
Typical copayment $16.42 (range $4.07 – $32.76)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Anesthetist, Certified Registered
1235 E CHEROKEE ST, ANESTHESIA
SPRINGFIELD, MO 65804
Specialist/Technologist (Athletic Trainer)
1235 E CHEROKEE ST
SPRINGFIELD, MO 65804
Specialist/Technologist (Athletic Trainer)
1235 E CHEROKEE ST
SPRINGFIELD, MO 65804
Specialist/Technologist (Athletic Trainer)
1235 E CHEROKEE ST
SPRINGFIELD, MO 65804
Specialist/Technologist (Athletic Trainer)
1235 E CHEROKEE ST
SPRINGFIELD, MO 65804
Specialist/Technologist (Athletic Trainer)
1235 E CHEROKEE ST
SPRINGFIELD, MO 65804
Specialist/Technologist (Athletic Trainer)
1235 E CHEROKEE ST
SPRINGFIELD, MO 65804
Physical Therapist (Sports)
1235 E CHEROKEE ST
SPRINGFIELD, MO 65804

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1083024970, enumerated as an "individual" on May 01, 2014.

The provider is located at 1235 E CHEROKEE ST SPRINGFIELD, MO 65804 and the phone number is (417) 820-3911.

Internal Medicine with taxonomy code 207RC0000X and a focus in Cardiovascular Disease.

The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to verify.

Clive Goulbourne is affiliated with: MERCY HOSPITAL JOPLIN, MERCY HOSPITAL LEBANON, MERCY HOSPITAL SPRINGFIELD, MERCY HOSPITAL AURORA and MERCY ST FRANCIS HOSPITAL.