Joan C Goddard, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD06754 Issued in RI

Practice address

180 Corliss St Ste B
Providence, RI 02904-2602

Phone

(401) 793-8400

Fax

(401) 793-8402

NPI assigned

Jun 27, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in RI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: joan.goddard.1@10.direct.athenahealth.com

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1225034077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 CORLISS ST STE B",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029042602",
            "telephone_number": "401-793-8400",
            "fax_number": "401-793-8402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 CORLISS ST STE B",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029042602",
            "telephone_number": "401-793-8400",
            "fax_number": "401-793-8402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODDARD",
        "first_name": "JOAN",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-27",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD06754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0181099",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7002212",
            "state": "RI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "joan.goddard.1@10.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "180 Corliss St Ste B",
            "city": "Providence",
            "state": "RI",
            "country_code": "US",
            "postal_code": "029042602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lauren Christine Glynn, MA, LMHC
• Lydie Helene Gnacadja, LICSW
• Douglas R Gnepp, M.D.
• Edmond Godbout, PA
• Jessica Godbout, PHARM.D.
• Mark James Godding, MD
• Frederick Augustus Godley III, M.D.
• Ridhima Goel, MD
• Ritu Goel, M.D.
• Semsa Gogcu, M.D.

• Internal Medicine Physician in Providence, RI
• Providers in Providence, RI by specialty
• Internal Medicine Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; 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.