Active NPI
Monica C Godwin, RN
- Family Nurse Practitioner
- Tacoma, WA
National Provider Identifier
1508402207
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP61194658
- Practice address
- 12180 Park Ave S
Tacoma, WA 98447-0014 - Phone
- (253) 535-7672
- NPI assigned
- Nov 18, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN60478347 | WA | |
| Family Nurse Practitioner | 363LF0000X | AP61194658 | WA | Primary |
Addresses
Primary practice location
12180 Park Ave S
Tacoma, WA 98447-0014
Mailing address
10725 Clark Rd SE
Yelm, WA 98597-9524
Phone (915) 539-9871
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner, Registered Nurse
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626048000000",
"number": "1508402207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10725 CLARK RD SE",
"city": "YELM",
"state": "WA",
"postal_code": "985979524",
"telephone_number": "915-539-9871"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12180 PARK AVE S",
"city": "TACOMA",
"state": "WA",
"postal_code": "984470014",
"telephone_number": "253-535-7672"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GODWIN",
"first_name": "MONICA",
"middle_name": "C",
"name_prefix": "Mrs.",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-11-18",
"last_updated": "2021-07-12",
"certification_date": "2021-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WA",
"license": "RN60478347",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WA",
"license": "AP61194658",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.