Goddard Medical Services LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

GODDARD MEDICAL SERVICES LLC

Practice address

9025 Coldwater Rd Ste 200
Fort Wayne, IN 46825-2097

Phone

(260) 459-9225

Fax

(608) 001-5122

NPI assigned

Jan 15, 2020

Organization subpart

No

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

Authorized official

Name

Sean Goddard, NP

Title

Owner

Phone

(812) 226-9600

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 3

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

• Karen Sams, LCSW

  • Clinical Social Worker
  • New Albany, IN
  • NPI 1265050686
  NPD
• Kelsi Dennis

  • Clinical Social Worker
  • New Albany, IN
  • NPI 1902301930
  NPD (past)
• Sonja Stang, LSW

  • Clinical Social Worker
  • New Albany, IN
  • NPI 1750888244
  NPD (past)

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

{
    "created_epoch": "1579046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708473600000",
    "number": "1659911832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9025 COLDWATER RD STE 200",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468252097",
            "telephone_number": "260-459-9225",
            "fax_number": "608-001-5122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9025 COLDWATER RD STE 200",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468252097",
            "telephone_number": "260-459-9225",
            "fax_number": "608-001-5122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GODDARD MEDICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-15",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A",
        "authorized_official_last_name": "GODDARD",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-226-9600",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "71008436A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebekah Anne Glunt, BCBA
• Elizabeth Glynn, MD
• Peter Yang Gaw Go, OTR
• Goal Setters, Inc
• Meghan Goble
• Eric M. Goddard, PA-C
• Sean Goddard, MSN, APRN, PMNHP-C,
• Robert W Godley, MD
• Jule L. Godsey, LCAC, MMHC
• Goebel Chiropractic

• Psychiatric/Mental Health Nurse Practitioner in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.