Tiffany Lynn Goddard
Individual provider Active NPI Personal Care Attendant · Proctor, WV
NPI 1073497285 · NPPES record last updated Aug 1, 2025
Key facts
- NPI
- 1073497285
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Personal Care Attendant 3747P1801X
- Practice address
- 1028 Campbell LN
Proctor, WV 26055-4193 - Phone
- (304) 551-2288
- NPI assigned
- Aug 1, 2025
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | Yes |
Addresses
Primary practice location
1028 Campbell LN
Proctor, WV 26055-4193
Mailing address
1028 Campbell LN
Proctor, WV 26055-4193
Phone (304) 551-2288
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 125553494 | Medicaid | WV | |
| 1356607394 | Medicaid | WV | |
| 1821206228 | Medicaid | WV |
Other providers in Proctor, WV
- Dorothy Marie Conrad
- Victoria Rose Cross
- Tia Danielle Eureka
- Kari Flamae Forrester
- Lynn Frohnapfel
- Valerie Helmic
- Mary Ann Kirkland
- Kristen O'Neil
- Michael Douglas Proctor
- Christina Lynn Riddle
All providers in Proctor, WV · Personal Care Attendant in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 1, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.