Individual provider Active NPI

Kelly Ann Burniston Godin, RN

  • Registered Nurse
  • Providence, RI
National Provider Identifier
1639728884
Registry record updated Sep 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
163W00000X Issued in RI
Practice address
530 N Main St
Providence, RI 02904-5762
Phone
(401) 228-6812
Fax
(401) 383-8163
NPI assigned
Sep 10, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 163W00000X RI Primary

Addresses

Primary practice location

530 N Main St
Providence, RI 02904-5762

Mailing address

530 N Main St
Providence, RI 02904-5762
Phone (401) 228-6812

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
163W00000XRIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1639728884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 N MAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045762",
            "telephone_number": "401-228-6812",
            "fax_number": "401-383-8163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 N MAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045762",
            "telephone_number": "401-228-6812",
            "fax_number": "401-383-8163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNISTON GODIN",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-10",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "RI",
            "license": "163W00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; 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.