Amanda Lee Goddard, RN, APRN

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

110662 Issued in NE

Practice address

5625 S 62ND St Ste 100
Lincoln, NE 68516-3558

Phone

(402) 489-3834

Fax

(402) 489-5049

NPI assigned

Sep 15, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Amanda Lee Thomas Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

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.

• Lincoln Pediatric Group LLC

  • Pediatrics Physician
  • Lincoln, NE
  • NPI 1083640130
  NPD
• Lincoln Pediatric Group LLC

  • Pediatrics Physician
  • Lincoln, NE
  • NPI 1508389610
  NPD

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1467558833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5625 S 62ND ST STE 100",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685163558",
            "telephone_number": "402-489-3834",
            "fax_number": "024-895-0494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5625 S 62ND ST STE 100",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685163558",
            "telephone_number": "402-489-3834",
            "fax_number": "402-489-5049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODDARD",
        "first_name": "AMANDA",
        "middle_name": "LEE",
        "credential": "RN, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NE",
            "license": "110662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026369300",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47079049100",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025151600",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47079049112",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "THOMAS",
            "middle_name": "LEE",
            "credential": "RN, APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sadie Jo Glynn
• Mary K Gobber, APRN
• Paul N. Gobbo
• Brynn Goble
• Donald Goble, PHARMD
• Jennifer Lynn Goddard, PT
• Rian Goddard
• Wendy Godejohn
• Joyzelle Effie Godfrey
• Melissa Godfrey

• Pediatric Nurse Practitioner in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Pediatric Nurse Practitioner in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.