Mackenzie Rose Goddard, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OC017046 Issued in PA

Practice address

1135 Olde W Chocolate Ave
Hummelstown, PA 17036-9188

Phone

(717) 832-2600

NPI assigned

Dec 11, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1607644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1356937528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 N CAVESSON DR",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082059665",
            "telephone_number": "609-335-3534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 OLDE W CHOCOLATE AVE",
            "city": "HUMMELSTOWN",
            "state": "PA",
            "postal_code": "170369188",
            "telephone_number": "717-832-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODDARD",
        "first_name": "MACKENZIE",
        "middle_name": "ROSE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-11",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC017046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Regina George, M.S., CCC-SLP
• Gale G. Georgeff, M.D.
• Tonya L Geppert, DPT
• Felicia Getz
• Virgil J Gibilterra, MS
• Michelle Godfrey
• Vidyottama Goel, M.D.
• Lynn Gomer
• Glendys Gonzalez
• Dudley R Gordon, MD

• Occupational Therapist in Hummelstown, PA
• Providers in Hummelstown, PA by specialty
• Occupational Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; 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.