Active NPI
Nikita Godbole, DPT
- Physical Therapist
- Decatur, GA
National Provider Identifier
1376190264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT014095
- Practice address
- 505 Irvin CT Ste 101
Decatur, GA 30030-1780 - Phone
- (404) 297-0821
- NPI assigned
- Aug 25, 2019
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT014095 | GA | Primary |
Addresses
Primary practice location
505 Irvin CT Ste 101
Decatur, GA 30030-1780
Mailing address
103 New Boca Way
Cary, NC 27518-9559
Phone (919) 961-0422
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Esop Rehabilitation, LLC | Physical Therapist | Current | Accepting new patients |
| Esop Rehabilitation, LLC | Physical Therapist | Current | Accepting new patients |
| Esop Rehabilitation LLC | Physical Therapist | Current | Accepting new patients |
Locations
875 Flat Shoals Rd SE
Ste 150
Conyers, GA 30094
Phone (770) 785-7669
505 Irvin Ct
Ste 101
Decatur, GA 30030
Phone (404) 297-0821
199 Medical Blvd
Stockbridge, GA 30281
Phone (404) 735-8212
Organizations & group practices 3
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.
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Physical Therapist
-
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- Conyers, GA
- NPI 1811319023
Physical Therapist
-
- Physical Therapy Clinic/Center
- Morrow, GA
- NPI 1780006825
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566691200000",
"number": "1376190264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 NEW BOCA WAY",
"city": "CARY",
"state": "NC",
"postal_code": "275189559",
"telephone_number": "919-961-0422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 IRVIN CT STE 101",
"city": "DECATUR",
"state": "GA",
"postal_code": "300301780",
"telephone_number": "404-297-0821"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GODBOLE",
"first_name": "NIKITA",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-25",
"last_updated": "2019-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT014095",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Decatur, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.