Lynette Rose Godbout, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PA2302 Issued in ME

Practice address

102 Campus Ave
Lewiston, ME 04240-6019

Phone

(207) 777-4219

NPI assigned

Mar 27, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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)

Not enrolled

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1134247307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 ROUTE 135",
            "city": "MONMOUTH",
            "state": "ME",
            "postal_code": "042596518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 CAMPUS AVE",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042406019",
            "telephone_number": "207-777-4219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODBOUT",
        "first_name": "LYNETTE",
        "middle_name": "ROSE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "ME",
            "license": "PA2302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Margery I Goldberg, LCSW
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• Jordan Goldstein, MD

• Physical Therapy Assistant in Lewiston, ME
• Providers in Lewiston, ME by specialty
• Physical Therapy Assistant in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.