NPIMap

Individual provider Active NPI

Ian Godfrey, PA-C

  • Physician Assistant
  • York, PA
National Provider Identifier
1730706433
Registry record updated Mar 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA061784 Issued in PA
Practice address
30 Monument Rd # 1100
York, PA 17403-5024
Phone
(717) 851-6454
Fax
(717) 851-1665
NPI assigned
Jun 29, 2020
Last updated
Mar 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA061784 PA Primary
Medical Physician Assistant 363AM0700X MG6281670 PA

Addresses

Primary practice location

30 Monument Rd # 1100
York, PA 17403-5024

Mailing address

3421 Concord Rd
York, PA 17402-9001
Phone (717) 851-6454

Other practice location 1

12 St Paul Dr
Chambersburg, PA 17201-1035
Phone (717) 217-6886

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, PA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210506001059 TN Practitioner - Physician Assistant 1658780507 Reassigns benefits to 1 organization
I20220708000142 PA Practitioner - Physician Assistant 1658780507 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Practice addresses (Care Compare)

1001 S George St
York, PA 17403-3676

1001 S George St 2ND Floor
Wellspan Pulmonary and Sleep Medicine
York, PA 17403-3676
Phone (717) 851-2465

25 Monument Rd
York, PA 17403-5073

2618 E Market St
Autumn House
York, PA 17403
Phone (717) 845-7214

30 Monument Rd
Suite 1100
York, PA 17403-5024
Phone (717) 812-2480

914 W Market St
Autumn House West
York, PA 17403
Phone (717) 845-7214

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Chattanooga Hamilton County Hospital Authority CurrentSince Jun 1, 2021 Accepting new patients
Wellspan Medical Group CurrentSince Jul 25, 2022 Accepting new patients
Chattanooga Hamilton County Hospital Authority CurrentSince Jun 1, 2021 Accepting new patients
Wellspan Medical Group Physician Assistant CurrentSince Jul 25, 2022 Accepting new patients
Wellspan Medical Group Past Accepting new patients

Locations

12 St Paul Dr
Chambersburg, PA 17201
Phone (717) 217-6026

501 E Main St
Waynesboro, PA 17268
Phone (717) 765-3400

1600 S George St
York, PA 17403
Phone (717) 848-3615

2149 S Queen St
York, PA 17403
Phone (717) 356-4460

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

3421 Concord Rd
York, PA 17402
Phone (717) 851-2441

975 E 3rd St
Chattanooga, TN 37403
Phone (423) 266-1499

979 E 3rd St
Ste C520
Chattanooga, TN 37403
Phone (423) 778-4465

Interoperability endpoints

  • Direct secure messaging: igodfrey224942@wellspan.direct-ci.com
  • Direct secure messaging: igodfrey76137@direct.erlanger.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1593388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1730706433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 CONCORD RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174029001",
            "telephone_number": "717-851-6454",
            "fax_number": "717-851-1665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MONUMENT RD # 1100",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174035024",
            "telephone_number": "717-851-6454",
            "fax_number": "717-851-1665"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12 St Paul Dr",
            "address_purpose": "LOCATION",
            "city": "Chambersburg",
            "state": "PA",
            "postal_code": "172011035",
            "country_code": "US",
            "telephone_number": "717-217-6886",
            "fax_number": "717-217-6896",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GODFREY",
        "first_name": "IAN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-29",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA061784",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MG6281670",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

Verify at the official NPI Registry.