Individual provider Active NPI

Richard Kohlstadt Godine, PA-C

  • Physician Assistant
  • Winston Salem, NC
National Provider Identifier
1285129759
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-08185 Issued in NC
Practice address
200 Robinhood Medical PLZ
Winston Salem, NC 27106-5471
Phone
(336) 718-7950
NPI assigned
Jun 27, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-08185 NC Primary

Addresses

Primary practice location

200 Robinhood Medical PLZ
Winston Salem, NC 27106-5471

Mailing address

PO Box 751803
Charlotte, NC 28275-1803

Other practice location 1

1995 Bethabara Rd
Winston Salem, NC 27106-3375
Phone (336) 759-7596

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rgodine654515@direct.novanthealth.org
Direct Messaging Address rgodine654515@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20180828001216 NC Practitioner - Physician Assistant 0042569899 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cora South Carolina LLCGroup PAC ID 3173766334, shared by 6 NPIs, 220 clinicians
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

18 Professional Village Cir
Beaufort, SC 29907-1570
Phone (843) 986-9670

1950 S Hawthorne Rd
Winston Salem, NC 27103-3912
Phone (336) 718-8386

2825 Lyndhurst Ave
Winston Salem, NC 27103-4146

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone (336) 277-1717

3641 Westgate Ctr Cir
Suite a
Winston Salem, NC 27103-4146
Phone (704) 384-8200

6915 Village Medical Cir
Clemmons, NC 27012-8002
Phone (336) 718-7080

Hospital & facility affiliations

  • Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014
  • Novant Health Medical Park Hospital Hospital, Winston-Salem, NC, CCN 340148

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Feb 13, 2022 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Feb 13, 2022 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: rgodine654515@direct.novanthealth.org

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1285129759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ROBINHOOD MEDICAL PLZ",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271065471",
            "telephone_number": "336-718-7950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1995 Bethabara Rd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271063375",
            "country_code": "US",
            "telephone_number": "336-759-7596",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GODINE",
        "first_name": "RICHARD",
        "middle_name": "KOHLSTADT",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-27",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-08185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rgodine654515@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1995 Bethabara Rd",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271063375",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rgodine654515@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "200 Robinhood Medical Plz",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271065471",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.