Jacy Kathleen Godsey, APRN-CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

250278 Issued in AZ

Practice address

23 S McNab Pkwy
San Manuel, AZ 85631-1156

Phone

(520) 385-2234

Fax

(520) 381-3209

NPI assigned

Jul 6, 2018

Last updated

Jan 26, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Jacy Kathleen Crowl Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1530835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1376039057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10097",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851300020",
            "telephone_number": "520-836-3446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 S MCNAB PKWY",
            "city": "SAN MANUEL",
            "state": "AZ",
            "postal_code": "856311156",
            "telephone_number": "520-385-2234",
            "fax_number": "520-381-3209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODSEY",
        "first_name": "JACY",
        "middle_name": "KATHLEEN",
        "name_prefix": "Mrs.",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-06",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "250278",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "106718",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACY",
            "last_name": "CROWL",
            "middle_name": "KATHLEEN",
            "prefix": "MS.",
            "credential": "RN-BSN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Nurse Practitioner in San Manuel, AZ
• Providers in San Manuel, AZ by specialty
• Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.

Verify at the official NPI Registry.