Michael K Goddard

Primary specialty

Day Training/Habilitation SpecialistTaxonomy code 373H00000X

Practice address

348 Northridge Dr Apt 104
Lewisburg, WV 24901-9053

Phone

(304) 520-4379

NPI assigned

Jun 24, 2020

Last updated

Jun 24, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1592956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1407472590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 11TH ST",
            "city": "RAINELLE",
            "state": "WV",
            "postal_code": "259621255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 NORTHRIDGE DR APT 104",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249019053",
            "telephone_number": "304-520-4379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODDARD",
        "first_name": "MICHAEL",
        "middle_name": "K",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-24",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Day Training/Habilitation Specialist in Lewisburg, WV
• Providers in Lewisburg, WV by specialty
• Day Training/Habilitation Specialist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; 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.