Active NPI
John Phillip Godfrey, PH.D.
- Clinical Psychologist
- Austin, TX
National Provider Identifier
1023029170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 25101
- Practice address
- 5750 Balcones Dr Ste 106
Austin, TX 78731-4268 - Phone
- (737) 202-5789
- Fax
- (737) 209-7080
- NPI assigned
- Aug 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 25101 | TX | |
| Adult Development & Aging Psychologist | 103TA0700X | 25101 | TX | |
| Cognitive & Behavioral Psychologist | 103TB0200X | 25101 | TX | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 25101 | TX | |
| Family Psychologist | 103TF0000X | 25101 | TX | |
| Clinical Psychologist | 103TC0700X | 25101 | TX | Primary |
Addresses
Primary practice location
5750 Balcones Dr Ste 106
Austin, TX 78731-4268
Mailing address
PO Box 152680
Austin, TX 78715-2680
Phone (512) 292-1122
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 160306 | Other | TX | VALUE OPTIONS |
| 040973202 | Medicaid | TX | |
| 0003LJ | Other | TX | BCBS NUMBER |
| 97034000 | Other | TX | MAGELLAN ID NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050203000456 | TX | Practitioner - Clinical Psychologist | 2062483464 | Practice locations: Austin, TX |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
5750 Balcones Dr
Suite 106
Austin, TX 78731-4268
Phone (737) 202-5789
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25101 | TX | MD | Clinical Child & Adolescent Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Morgan Morris Counseling Associates LLP | Past | Accepting new patients |
Organizations & group practices 1
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.
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- NPI 1821479056
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682553600000",
"number": "1023029170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 152680",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787152680",
"telephone_number": "512-292-1122",
"fax_number": "512-292-1144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5750 BALCONES DR STE 106",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787314268",
"telephone_number": "737-202-5789",
"fax_number": "737-209-7080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GODFREY",
"first_name": "JOHN",
"middle_name": "PHILLIP",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-11",
"last_updated": "2023-04-27",
"certification_date": "2023-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TX",
"license": "25101",
"primary": false
},
{
"code": "103TA0700X",
"taxonomy_group": "",
"desc": "Psychologist, Adult Development & Aging",
"state": "TX",
"license": "25101",
"primary": false
},
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "TX",
"license": "25101",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "TX",
"license": "25101",
"primary": false
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": "TX",
"license": "25101",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "25101",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "160306",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "040973202",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS NUMBER",
"identifier": "0003LJ",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN ID NUMBER",
"identifier": "97034000",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.