Kimberly R Tartt-Godbolt, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1879 Issued in AL

Practice address

4444 Demetropolis Rd
Mobile, AL 36619-9602

Phone

(251) 219-3942

NPI assigned

Apr 10, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

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.

• Athena Consulting and Psychological Services, PLLC

  dba Athena Care

  • Clinical Psychologist
  • Nashville, TN
  • NPI 1336292465
  NPD (past)
• Tennessee TMS Center, PLLC

  • Psychiatry Physician
  • Nashville, TN
  • NPI 1649637133
  NPD (past)

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1093938052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4444 DEMETROPOLIS RD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366199602",
            "telephone_number": "251-219-3942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 DEMETROPOLIS RD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366199602",
            "telephone_number": "251-219-3942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARTT-GODBOLT",
        "first_name": "KIMBERLY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AL",
            "license": "1879",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Tanner
• Sarita Tanner, RN
• Matthew Tao
• Tara Festa OD LLC (Hillcrest Optical)
• Roger P Tart, MD
• Kimberly Tarver
• Carmen Tate
• Julia Christine Tatman
• Paul Michael Taupeka, M.D.
• Tristan Tave, DNP, CRNP, PMHNP-BC

• Clinical Psychologist in Mobile, AL
• Providers in Mobile, AL by specialty
• Clinical Psychologist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; 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.