Rae Jeanna Godsey, D.O.
Individual provider Active NPI Family Medicine Physician · Charlestown, IN
NPI 1124024088 · NPPES record last updated Mar 7, 2023
Key facts
- NPI
- 1124024088
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 02002615A (IN)
- Practice address
- 2100 Market St
Ste 100
Charlestown, IN 47111-9535 - Phone
- (812) 256-0700
- Fax
- (812) 256-0704
- NPI assigned
- Jun 24, 2005
- Reactivated
- Mar 24, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02002615A | IN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bes of Ohio, LLC, Dba Medgroup | Past | Accepting new patients | |
| Southern Indiana Orthopedic & Spine Surgery, PSC | Past | Accepting new patients | |
| Bes of Ohio, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 02002615A | IN | Yes |
Addresses
Primary practice location
2100 Market St
Ste 100
Charlestown, IN 47111-9535
Mailing address
1502 Tunnel Mill Rd
Charlestown, IN 47111-9216
Phone (812) 256-0700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200441850A | Medicaid | IN | |
| 7022469 | Other | AETNA | |
| 1209485 | Other | IN | CHA HEALTH |
| 000000301780 | Other | ANTHEM | |
| 02002615A | Other | IN | STATE LICENSE |
| 15D1020413 | Other | CLIA | |
| 64079213 | Medicaid | KY | |
| 907008 | Other | USA MCO |
Other providers in Charlestown, IN
- Laura George
- Hannah Gibson
- Heather Gibson
- Christina Ranea Gilkey
- Raymie Charles Gill
- Lea Goodin
- Eric L. Gordon
- Laurhyn Griebel
- Travis Lee Gross
- Michael Grubbs
All providers in Charlestown, IN · Family Medicine Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2023. 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.