Keely B Godwin, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

200200328 Issued in NC

Practice address

1031 W Williams St
Suite106
Apex, NC 27502-3955

Phone

(919) 363-0190

Fax

(919) 363-0195

NPI assigned

Jul 7, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Sep 27, 2013 through Sep 27, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Brier Creek Integrated Pain & Spine PLLC

  • Medical Specialty Clinic/Center
  • Raleigh, NC
  • NPI 1538352760
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364342400000",
    "number": "1013940964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 W WILLIAMS ST",
            "address_2": "SUITE106",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275023955",
            "telephone_number": "919-363-0190",
            "fax_number": "919-363-0195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 W WILLIAMS ST",
            "address_2": "SUITE106",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275023955",
            "telephone_number": "919-363-0190",
            "fax_number": "919-363-0195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODWIN",
        "first_name": "KEELY",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2013-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "200200328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5912910",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "132RU",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "132RU",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89132RU",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7154477",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen Glees
• Evan Gliptis
• Jamie Cash Glover, NP
• Camilla Anne Glovier, OT/L
• Laurie Fulton Godfrey, M.S., CCC-SLP
• Noopur Goel
• Taryn Goldberg, PHD, NCSP
• Annie Kaye Goldblatt
• Lacey Rae Golick, PA
• Nicole Golinski, RDN

• Family Medicine Physician in Apex, NC
• Providers in Apex, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.