Individual provider Active NPI

Georges P. Godfrin, NP

  • Family Nurse Practitioner
  • Clinton, SC
National Provider Identifier
1184665861
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN 1662 Issued in SC
Practice address
245 Human Services Rd
Clinton, SC 29325-7548
Phone
(864) 554-1970
NPI assigned
Jun 10, 2006
Last updated
Nov 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN 1662 SC Primary

Addresses

Primary practice location

245 Human Services Rd
Clinton, SC 29325-7548

Mailing address

112 Amherst Dr
Greenwood, SC 29649-8901
Phone (864) 554-1970

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031120000865 SC Practitioner - Nurse Practitioner 2466356571 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1662SCMDChiropractor
APN 1662SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Rehab Consultants PLLC Family CurrentSince Feb 15, 2024 Accepting new patients
Prisma Health University Medical Group Past Accepting new patients
Self Regional Healthcare Past Accepting new patients
Southeastern Emergency Services P C Past Accepting new patients

Locations

415 W Golf Rd
Ste 26
Arlington Hts, IL 60005

1810 Richmond Ave
Port Royal, SC 29935
Phone (843) 781-7700

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1184665861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 AMHERST DR",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296498901",
            "telephone_number": "864-554-1970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 HUMAN SERVICES RD",
            "city": "CLINTON",
            "state": "SC",
            "postal_code": "293257548",
            "telephone_number": "864-554-1970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODFRIN",
        "first_name": "GEORGES",
        "middle_name": "P.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "APN 1662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, SC

Sources for this page

Verify at the official NPI Registry.