Individual provider Active NPI

Shannon Kathleen Godsil, M.D.

  • Pediatrics Physician
  • Gretna, NE
National Provider Identifier
1518306414
Registry record updated Dec 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
29266 Issued in NE
Practice address
11946 Standing Stone Dr
Gretna, NE 68028-8094
Phone
(402) 815-4500
Fax
(402) 815-4510
NPI assigned
Jun 24, 2013
Last updated
Dec 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 29266 NE Primary
Pediatrics Physician 208000000X TEP#6973 NE

Addresses

Primary practice location

11946 Standing Stone Dr
Gretna, NE 68028-8094

Mailing address

PO Box 3755
Omaha, NE 68103-0755
Phone (402) 354-2100

Other names 1

  • Miss Shannon Kathleen Hardy Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160623002117 NE Practitioner - Pediatric Medicine 1658594775 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6973NEMDDentist
29266NEMDPediatrics Physician
TEP#6973NEMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Clinic Inc Pediatrics CurrentSince Dec 31, 2025 Accepting new patients

Locations

11946 Standing Stone Dr
Gretna, NE 68028
Phone (402) 354-2273

10060 Regency Cir
Omaha, NE 68114
Phone (402) 354-1405

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1372032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767052800000",
    "number": "1518306414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3755",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681030755",
            "telephone_number": "402-354-2100",
            "fax_number": "402-354-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11946 STANDING STONE DR",
            "city": "GRETNA",
            "state": "NE",
            "postal_code": "680288094",
            "telephone_number": "402-815-4500",
            "fax_number": "402-815-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODSIL",
        "first_name": "SHANNON",
        "middle_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-24",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "29266",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "TEP#6973",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "HARDY",
            "middle_name": "KATHLEEN",
            "prefix": "MISS",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gretna, NE

Sources for this page

Verify at the official NPI Registry.