Active NPI
Goddard Medical, LLC
- General Practice Physician
- Overland Park, KS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- Legal business name
- GODDARD MEDICAL, LLC
- Practice address
- 11936 W 119TH St # 158
Overland Park, KS 66213-2216 - Phone
- (913) 735-9044
- NPI assigned
- Feb 1, 2021
- Last updated
- Feb 25, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Maria Sheelene Goddard, MD
- Title
- Chief Executive Officer
- Phone
- (913) 735-9044
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | Primary |
Addresses
Primary practice location
11936 W 119TH St # 158
Overland Park, KS 66213-2216
Mailing address
11936 W 119TH St # 158
Overland Park, KS 66213-2216
Phone (913) 735-9044
National Provider Directory
National Provider DirectoryLocations
11936 W 119th St
#158
Overland Park, KS 66213
Phone (913) 735-9044
Interoperability endpoints
- https://api.platform.athenahealth.com/23569/brand/1/csg/1/fhir/r4
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Surgery Physician
- Overland Park, KS
- NPI 1376798785
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612137600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1614211200000",
"number": "1366033359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11936 W 119TH ST # 158",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "662132216",
"telephone_number": "913-735-9044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11936 W 119TH ST # 158",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "662132216",
"telephone_number": "913-735-9044"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GODDARD MEDICAL, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-02-01",
"last_updated": "2021-02-25",
"certification_date": "2021-02-08",
"status": "A",
"authorized_official_last_name": "GODDARD",
"authorized_official_first_name": "MARIA",
"authorized_official_middle_name": "SHEELENE",
"authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
"authorized_official_telephone_number": "913-735-9044",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "General Practice",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Overland Park, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.