Organization Active NPI

Angela M. Godwin, Nurse Practitioner in Family Health, PLLC.

  • Family Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1669884748
Registry record updated May 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F335139-1 Issued in NY
Legal business name
ANGELA M. GODWIN, NURSE PRACTITIONER IN FAMILY HEALTH, PLLC.
Practice address
1469 Astor Ave
Bronx, NY 10469-5846
Phone
(347) 871-3774
NPI assigned
May 23, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2022

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

Authorized official

Name
Miss Debra Rodriguez
Title
Practice Manager
Phone
(646) 457-8127

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X F335139-1 NY Primary

Addresses

Primary practice location

1469 Astor Ave
Bronx, NY 10469-5846

Mailing address

12001 Avalon Lake Dr Apt 326
Orlando, FL 32828-7379
Phone (646) 457-8127

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141112000098 NY Part B Supplier - Clinic/Group Practice 9032331855 Receives reassigned benefits from 2 practitioners
Practice locations: Bronx, NY; Staten Island, NY

National Provider Directory

National Provider Directory

Locations

88 New Dorp Plz S
Staten Island, NY 10306
Phone (347) 466-1952

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1400803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651449600000",
    "number": "1669884748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12001 AVALON LAKE DR APT 326",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328287379",
            "telephone_number": "646-457-8127",
            "fax_number": "347-824-2978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1469 ASTOR AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104695846",
            "telephone_number": "347-871-3774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELA M. GODWIN, NURSE PRACTITIONER IN FAMILY HEALTH, PLLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-23",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "646-457-8127",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F335139-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.