Craig Godfrey, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-5204 Issued in ID

Practice address

1001 N 7TH Ave Ste 280
Pocatello, ID 83201-5788

Phone

(208) 239-1490

NPI assigned

Jun 29, 2022

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)

Enrolled

State licenses

Practice roles

Locations

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.

• Pocatello Health Services, LLC

  • General Acute Care Hospital
  • Pocatello, ID
  • NPI 1689802852
  NPD
• Pocatello Hospital LLC

  • Internal Medicine Physician
  • Pocatello, ID
  • NPI 1760610935
  NPD
• Pocatello Hospital LLC

  • Psychiatric Hospital Unit
  • Pocatello, ID
  • NPI 1295777274
  NPD (past)

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

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1457083370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 N 7TH AVE STE 205",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015761",
            "telephone_number": "208-239-1490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 N 7TH AVE STE 280",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015788",
            "telephone_number": "208-239-1490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODFREY",
        "first_name": "CRAIG",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-29",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-5204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana Gilmore, FNP
• Deanna Emilia Giokas, LMT
• Geno Alan Giovanini
• Kellie Alyse Glock, TSLP
• Tia Marie Godfrey-Floyd
• Glenn William Godfrey, DDS
• Jonathan D Godfrey, M.D.
• Matthew P Godfrey, D.D.S.
• Michael Wynn Godfrey, DMD
• Bethany Gold, DO

• Physical Therapist in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; 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.