Individual provider Active NPI

Shelly Pomplin Godar, M.A., CCC-A

  • Audiologist
  • Madison, WI
National Provider Identifier
1134589989
Registry record updated Mar 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
156-376 Issued in WI
Practice address
1500 Highland Ave
Waisman Center Clinics
Madison, WI 53705-2274
Phone
(608) 263-3301
Fax
(608) 265-7429
NPI assigned
Mar 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 156-376 WI Primary

Addresses

Primary practice location

1500 Highland Ave
Waisman Center Clinics
Madison, WI 53705-2274

Mailing address

1500 Highland Ave
Waisman Center Clinics
Madison, WI 53705-2274
Phone (608) 263-3301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
156-376WIMDAudiologist

NPI Registry JSON

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

{
    "created_epoch": "1457308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457308800000",
    "number": "1134589989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 HIGHLAND AVE",
            "address_2": "WAISMAN CENTER CLINICS",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537052274",
            "telephone_number": "608-263-3301",
            "fax_number": "608-265-7429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 HIGHLAND AVE",
            "address_2": "WAISMAN CENTER CLINICS",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537052274",
            "telephone_number": "608-263-3301",
            "fax_number": "608-265-7429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODAR",
        "first_name": "SHELLY",
        "middle_name": "POMPLIN",
        "credential": "M.A., CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-07",
        "last_updated": "2016-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "WI",
            "license": "156-376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2016; 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.