Mini B Goddard M D P C

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

4301064837 Issued in MI

Legal business name

MINI B GODDARD M D P C

Practice address

14600 King Rd
Suite a
Riverview, MI 48193-7952

Phone

(734) 479-7800

Fax

(734) 479-7802

NPI assigned

Jan 23, 2007

Organization subpart

No

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

Authorized official

Name

Mini B Goddard, M.D.NPI 1326033754

Title

President

Phone

(734) 479-7800

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mini B Goddard, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Westerville, OH
  • NPI 1326033754
  NPD (past) Authorized official

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528112679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14600 KING RD",
            "address_2": "SUITE A",
            "city": "RIVERVIEW",
            "state": "MI",
            "postal_code": "481937952",
            "telephone_number": "734-479-7800",
            "fax_number": "734-479-7802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14600 KING RD",
            "address_2": "SUITE A",
            "city": "RIVERVIEW",
            "state": "MI",
            "postal_code": "481937952",
            "telephone_number": "734-479-7800",
            "fax_number": "734-479-7802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINI B GODDARD M D P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GODDARD",
        "authorized_official_first_name": "MINI",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-479-7800",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "4301064837",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4682722",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "2508232231",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lorraine Mexicotte
• Michael a Freedman D.O. P.C.
• Anthony Michael
• Kristen Miller-Lauzon, DDS
• Ida Mae Miller
• Arshiya Rahman Mirza, D.O.
• Rajeev Mittal, PT
• Shahed Mohamed
• Noor Mohammed, M.D.
• Michelle M Monday, PTA

• Physical Medicine & Rehabilitation Physician in Riverview, MI
• Providers in Riverview, MI by specialty
• Physical Medicine & Rehabilitation Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.