NPIMap

Individual provider Active NPI

Craig R Godfrey, D.O.

  • Internal Medicine Physician
  • Meadville, PA
National Provider Identifier
1376575738
Registry record updated Feb 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS004699L Issued in PA
Practice address
765 Liberty St
Suite # 301
Meadville, PA 16335-2566
Phone
(814) 724-8363
Fax
(814) 724-8343
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS004699L PA Primary

Addresses

Primary practice location

765 Liberty St
Suite # 301
Meadville, PA 16335-2566

Mailing address

765 Liberty St
Suite # 301
Meadville, PA 16335-2566
Phone (814) 724-8363

Other identifiers 1

IdentifierTypeStateIssuer
127917OtherPABLUE CROSS / SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071003000708 PA Practitioner - Internal Medicine 3577658608 Reassigns benefits to 1 organization
Practice locations: Conneautville, PA; Meadville, PA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Philadelphia College of Osteopathic Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meadville Medical Center 139 clinicians

Practice addresses (Care Compare)

751 Liberty St
Meadville, PA 16335-2559
Phone (814) 333-5155

Hospital & facility affiliations

  • Meadville Medical Center Hospital, Meadville, PA, CCN 390113
  • Titusville Area Hospital Hospital, Titusville, PA, CCN 391314

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Meadville Medical Center Internal Medicine CurrentSince Aug 23, 1983 Accepting new patients
Pioneer Medical Associates Internal Medicine Current Accepting new patients
Meadville Medical Center CurrentSince Aug 23, 1983 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

765 Liberty St
Ste 307
Meadville, PA 16335
Phone (814) 336-1140

751 Liberty St
Meadville, PA 16335
Phone (814) 333-5081

1015 Grove St
Meadville, PA 16335
Phone (814) 337-5894

1034 Grove St
Meadville, PA 16335
Phone (814) 333-5728

Interoperability endpoints

  • Direct secure messaging: craig.r.godfrey@directaddress.net

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Meadville Medical CenterMeadville, PA, CCN 390113 Hospital Corporate Director Oct 1, 2024
Meadville Medical Center Transitional Care UnitMeadville, PA, CCN 395894 Skilled nursing facility Corporate Director Dec 1, 2021

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 23

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.

View all 23

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202860800000",
    "number": "1376575738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 LIBERTY ST",
            "address_2": "SUITE # 301",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163352566",
            "telephone_number": "814-724-8363",
            "fax_number": "814-724-8343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 LIBERTY ST",
            "address_2": "SUITE # 301",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163352566",
            "telephone_number": "814-724-8363",
            "fax_number": "814-724-8343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODFREY",
        "first_name": "CRAIG",
        "middle_name": "R",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2008-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS004699L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS / SHIELD",
            "identifier": "127917",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meadville, PA

Sources for this page

Verify at the official NPI Registry.