Individual provider Active NPI

Carlos Godoy

  • Contractor
  • Tucson, AZ
National Provider Identifier
1215316120
Registry record updated Nov 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
6954828 Issued in AZ
Practice address
6108 E Bramble St
Tucson, AZ 85756
Phone
(520) 437-2437
NPI assigned
May 26, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 6954828 AZ Primary

Addresses

Primary practice location

6108 E Bramble St
Tucson, AZ 85756

Mailing address

Intermountain Centers for Human Development Inc
994 S Harrison Rd
Tucson, AZ 85748
Phone (520) 721-1887

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

State licenses

LicenseStateTypeSpecialty
6954828AZMDContractor

NPI Registry JSON

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

{
    "created_epoch": "1432598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573516800000",
    "number": "1215316120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "INTERMOUNTAIN CENTERS FOR HUMAN DEVELOPMENT INC",
            "address_2": "994 S HARRISON RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85748",
            "telephone_number": "520-721-1887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6108 E BRAMBLE ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85756",
            "telephone_number": "520-437-2437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODOY",
        "first_name": "CARLOS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-26",
        "last_updated": "2019-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "AZ",
            "license": "6954828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2019; 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.