Shellie Ann Godina

Primary specialty

DentistTaxonomy code 122300000X

License

12011803A Issued in IN

Practice address

422 N Benton St
Millersburg, IN 46543-9732

Phone

(574) 642-4449

NPI assigned

Feb 26, 2013

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Springer Dental Care of Millersburg

  • Dentist
  • Millersburg, IN
  • NPI 1003345216
  NPD (past)

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

{
    "created_epoch": "1361836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1154661247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58724 FAWN RIVER CT",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465166200",
            "telephone_number": "574-238-5470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 N BENTON ST",
            "city": "MILLERSBURG",
            "state": "IN",
            "postal_code": "465439732",
            "telephone_number": "574-642-4449"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3702 E Mishawaka Rd",
            "address_purpose": "LOCATION",
            "city": "Elkhart",
            "state": "IN",
            "postal_code": "465173550",
            "country_code": "US",
            "telephone_number": "574-875-6595",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GODINA",
        "first_name": "SHELLIE",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-26",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011803A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Lyle Baer, D.D.S.
• Kelsey Marie Edwards, SBD
• Holley Chiropractic, LLC (Community Chiropractic & Wellness Center)
• Alexis Holthues
• Eric McAlister, DC
• Middlebury Family Physicians, Inc (Millersburg Family Physicians)
• Millersburg-Clinton Fire Territory

• Dentist in Millersburg, IN
• Providers in Millersburg, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.