Active NPI
Stephen E Godfrey, MD
- Anatomic Pathology & Clinical Pathology Physician
- St Louis, MO
National Provider Identifier
1366431595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- R2C59
- Practice address
- 10010 Kennerly Road
St Louis, MO 63128 - Phone
- (314) 525-4345
- Fax
- (314) 525-4354
- NPI assigned
- Oct 20, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | R2C59 | MO | Primary |
Addresses
Primary practice location
10010 Kennerly Road
St Louis, MO 63128
Mailing address
5675-D Golf Ridge Drive
St Louis, MO 63128
Phone (314) 401-5161
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201838810 | Medicaid | MO | |
| 220027908 | Other | RAILROAD MEDICARE |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R2C59 | MO | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Louis University | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Optician
- Saint Louis, MO
- NPI 1487869863
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216771200000",
"number": "1366431595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5675-D GOLF RIDGE DRIVE",
"city": "ST LOUIS",
"state": "MO",
"postal_code": "63128",
"telephone_number": "314-401-5161",
"fax_number": "314-525-4354"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10010 KENNERLY ROAD",
"city": "ST LOUIS",
"state": "MO",
"postal_code": "63128",
"telephone_number": "314-525-4345",
"fax_number": "314-525-4354"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GODFREY",
"first_name": "STEPHEN",
"middle_name": "E",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-20",
"last_updated": "2008-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "MO",
"license": "R2C59",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201838810",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "220027908",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in St Louis, MO
- Tracey Lynn Godbold, MD
- Rebecca Ann Godefroid-Lamperti, PHARMD
- Adam Godefroid, RN, BSN, CCM
- Julie Ann Godefroid, FNP-BC
- Caroline Marie Godfrey, MD
- Kelsey Lynn Godier, DO, MPH
- Gods Helping Hands Homecare LLC
- Gods Love Is Here Home Health Agency
- Gods Love Is Here in Home Health LLC
- Godwin Chiropractic LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.