Imelda Godbold, RN

Primary specialty

Case Management Registered NurseTaxonomy code 163WC0400X

License

28170434A Issued in IN

Practice address

420 W 4TH St
Suite 100-a
Mishawaka, IN 46544-1948

Phone

(574) 252-0317

Fax

(574) 472-3694

NPI assigned

Oct 14, 2008

Last updated

Oct 14, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1223942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223942400000",
    "number": "1780836395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6864 FIR RD",
            "city": "BREMEN",
            "state": "IN",
            "postal_code": "465069718",
            "telephone_number": "574-342-6015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W 4TH ST",
            "address_2": "SUITE 100-A",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465441948",
            "telephone_number": "574-252-0317",
            "fax_number": "574-472-3694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODBOLD",
        "first_name": "IMELDA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-14",
        "last_updated": "2008-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "IN",
            "license": "28170434A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glenn S. Wheet, MD, PC
• Bryan C Glenn, D.C.
• Lorrajean A Gleva
• Jessica A Gnoth
• Destinee Goble
• Haley Goethals, MS
• Meghan Goltowski, PT
• Francisco Javier Gomez-Dossi, M.D.
• Luis Felipe Gomez, M.D.
• Alyssa Joy Good

• Case Management Registered Nurse in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Case Management Registered Nurse in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2008; 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.