NPIMap

Individual provider Active NPI

Gabrielle Godfrey

  • Driver
  • Suffolk, VA
National Provider Identifier
1265077291
Registry record updated Nov 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
License
A60366253 Issued in VA
Practice address
1019 Nicklaus Dr
Suffolk, VA 23435-4102
Phone
(757) 537-9010
NPI assigned
Nov 13, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DriverGroup: 193400000X SINGLE SPECIALTY GROUP 172A00000X A60366253 VA Primary

Addresses

Primary practice location

1019 Nicklaus Dr
Suffolk, VA 23435-4102

Mailing address

3575 Bridge Rd
Suite 8 PMB 208
Suffolk, VA 23435

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL SUFFOLK

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
A60366253VAMDDriver

NPI Registry JSON

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

{
    "created_epoch": "1573603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1265077291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3575 BRIDGE RD",
            "address_2": "SUITE 8 PMB 208",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "23435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 NICKLAUS DR",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234354102",
            "telephone_number": "757-537-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODFREY",
        "first_name": "GABRIELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-13",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Driver",
            "state": "VA",
            "license": "A60366253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "SUFFOLK",
            "affiliation": "N",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1019 Nicklaus Dr",
            "city": "Suffolk",
            "state": "VA",
            "country_code": "US",
            "postal_code": "234354102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.