Active NPI
Stephen Dayton Goddard
- Physical Therapist
- Williamstown, WV
National Provider Identifier
1144609264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT1602
- Practice address
- 282 Valley Manor LN
Williamstown, WV 26187-8260 - Phone
- (304) 375-1990
- NPI assigned
- May 21, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT7749 | OH | |
| Physical Therapist | 225100000X | PT1602 | WV | Primary |
Addresses
Primary practice location
282 Valley Manor LN
Williamstown, WV 26187-8260
Mailing address
282 Valley Manor LN
Williamstown, WV 26187-8260
Phone (304) 375-1990
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT7749 | OH | MD | Physical Therapist |
| PT1602 | WV | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432166400000",
"number": "1144609264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "282 VALLEY MANOR LN",
"city": "WILLIAMSTOWN",
"state": "WV",
"postal_code": "261878260",
"telephone_number": "304-375-1990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "282 VALLEY MANOR LN",
"city": "WILLIAMSTOWN",
"state": "WV",
"postal_code": "261878260",
"telephone_number": "304-375-1990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GODDARD",
"first_name": "STEPHEN",
"middle_name": "DAYTON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-05-21",
"last_updated": "2015-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "PT7749",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WV",
"license": "PT1602",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Williamstown, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.