Gail Katherine Godwin, PHD, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN069333 Issued in GA

Practice address

2927 Demere Rd
Saint Simons Is, GA 31522-1620

Phone

(912) 638-1999

NPI assigned

Dec 9, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1575849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575849600000",
    "number": "1053958181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 78",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310590078",
            "telephone_number": "470-522-9270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2927 DEMERE RD",
            "city": "SAINT SIMONS IS",
            "state": "GA",
            "postal_code": "315221620",
            "telephone_number": "912-638-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODWIN",
        "first_name": "GAIL",
        "middle_name": "KATHERINE",
        "name_prefix": "Dr.",
        "credential": "PHD, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-09",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN069333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raleeta Dianne Davis, MEDCCCSLP
• Dental Center of St Simons
• Hunter Farthing, MS, RDN, LDN
• Ronald Tracy Gerken, RPH
• Matthew Mackinnon Gibbs
• Karen Heller Griffith, RPH
• Stephanie Griggs, ATC
• Mary Janus, CCC-SLP
• Kari E. Kizzire, DPT
• Trinity Martin

• All providers in Saint Simons Is, GA
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2019; 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.