NPIMap

Individual provider Active NPI

Patrick L Godwin, MD

  • Internal Medicine Physician
  • Roxboro, NC
National Provider Identifier
1164483483
Registry record updated Feb 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9501254 Issued in NC
Practice address
609 Professional Dr
Roxboro, NC 27573
Phone
(336) 599-9257
Fax
(336) 599-1593
NPI assigned
Mar 28, 2006
Last updated
Feb 22, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 9501254 NC Primary
Pediatrics Physician 208000000X 9501254 NC

Addresses

Primary practice location

609 Professional Dr
Roxboro, NC 27573

Mailing address

609 Professional Dr
Roxboro, NC 27573
Phone (336) 599-9257

Other identifiers 1

IdentifierTypeStateIssuer
891005RMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040102000364 NC Practitioner - Pediatric Medicine 2466350012 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of North Carolina at Chapel Hill School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North State Medical Center PAGroup PAC ID 2769380310, 2 clinicians

Practice addresses (Care Compare)

609 Professional Dr
Roxboro, NC 27573-4543
Phone (336) 599-9257

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
North State Medical Center PA Internal Medicine CurrentSince Jan 1, 1998 Accepting new patients
Raleigh Durham Medical Group PA Internal Medicine Past Accepting new patients

Locations

609 Professional Dr
Roxboro, NC 27573
Phone (336) 599-9257

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JJEGBA/Endpoint/JJEGBA
  • Direct secure messaging: patrick.godwin@nsmc.eclinicaldirectplus.com

Organizations & group practices 2

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329868800000",
    "number": "1164483483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 PROFESSIONAL DR",
            "city": "ROXBORO",
            "state": "NC",
            "postal_code": "27573",
            "telephone_number": "336-599-9257",
            "fax_number": "336-599-1593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 PROFESSIONAL DR",
            "city": "ROXBORO",
            "state": "NC",
            "postal_code": "27573",
            "telephone_number": "336-599-9257",
            "fax_number": "336-599-1593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODWIN",
        "first_name": "PATRICK",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2012-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "9501254",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "9501254",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891005R",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roxboro, NC

Sources for this page

Verify at the official NPI Registry.