Individual provider Active NPI

Danielle Godfrey, RN,MSN,RNC-MNN,IBCLC

  • Lactation Consultant (Registered Nurse)
  • Port Orange, FL
National Provider Identifier
1720794613
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
9565465 Issued in FL
Practice address
3510 S Nova Rd Ste 111
Port Orange, FL 32129-3796
Phone
(386) 310-9401
NPI assigned
Jan 25, 2023
Last updated
Apr 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal Newborn Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WM0102X 9565465 FL
Lactation Consultant (Registered Nurse) 163WL0100X 9565465 FL Primary

Addresses

Primary practice location

3510 S Nova Rd Ste 111
Port Orange, FL 32129-3796

Mailing address

960 Countryside West Blvd
Port Orange, FL 32127-7988

Other practice location 1

125 W Plymouth Ave Ste A
Deland, FL 32720-2745
Phone (386) 310-9401

Other practice location 2

960 Countryside West Blvd
Port Orange, FL 32127-7988
Phone (386) 310-9401

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
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
9565465FLMDMaternal Newborn Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1674604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1720794613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 COUNTRYSIDE WEST BLVD",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321277988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 S NOVA RD STE 111",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321293796",
            "telephone_number": "386-310-9401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 W Plymouth Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Deland",
            "state": "FL",
            "postal_code": "327202745",
            "country_code": "US",
            "telephone_number": "386-310-9401",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "960 Countryside West Blvd",
            "address_purpose": "LOCATION",
            "city": "Port Orange",
            "state": "FL",
            "postal_code": "321277988",
            "country_code": "US",
            "telephone_number": "386-310-9401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GODFREY",
        "first_name": "DANIELLE",
        "credential": "RN,MSN,RNC-MNN,IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-25",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Maternal Newborn",
            "state": "FL",
            "license": "9565465",
            "primary": false
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "FL",
            "license": "9565465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; 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.