Active NPI
Susanne Godsey, PA-C
- Physician Assistant
- Stamford, CT
National Provider Identifier
1356630321
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 3168
- Practice address
- 1180 Newfield Ave
Stamford, CT 06905-1409 - Phone
- (314) 888-5233
- NPI assigned
- Mar 30, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 3168 | CO | Primary |
Addresses
Primary practice location
1180 Newfield Ave
Stamford, CT 06905-1409
Mailing address
1180 Newfield Ave
Stamford, CT 06905-1409
Phone (314) 888-5233
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04686055 | Medicaid | CO |
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3168 | CO | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1301443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679011200000",
"number": "1356630321",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1180 NEWFIELD AVE",
"city": "STAMFORD",
"state": "CT",
"postal_code": "069051409",
"telephone_number": "314-888-5233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1180 NEWFIELD AVE",
"city": "STAMFORD",
"state": "CT",
"postal_code": "069051409",
"telephone_number": "314-888-5233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GODSEY",
"first_name": "SUSANNE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-03-30",
"last_updated": "2023-03-17",
"certification_date": "2023-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CO",
"license": "3168",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "04686055",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Stamford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.