Individual provider Active NPI

Pius N Godwin, ARNP

  • Nurse Practitioner
  • Lakeland, FL
National Provider Identifier
1831187012
Registry record updated Aug 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP1921112 Issued in FL
Practice address
1267 Timberidge Loop N
Lakeland, FL 33809-4682
Phone
(863) 602-7908
Fax
(863) 815-1901
NPI assigned
Oct 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP1921112 FL Primary
Gerontology Nurse Practitioner 363LG0600X R78479 FL

Addresses

Primary practice location

1267 Timberidge Loop N
Lakeland, FL 33809-4682

Mailing address

117 W Alexander St Ste 387
Plant City, FL 33563-7155
Phone (813) 754-7756

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040823000645 FL Practitioner - Nurse Practitioner 3072586767 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R78479FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kindhearted Assisted Living Facility, Inc. Past Accepting new patients
Radiation Oncology of West Florida Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217548800000",
    "number": "1831187012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 W ALEXANDER ST STE 387",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335637155",
            "telephone_number": "813-754-7756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1267 TIMBERIDGE LOOP N",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338094682",
            "telephone_number": "863-602-7908",
            "fax_number": "863-815-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODWIN",
        "first_name": "PIUS",
        "middle_name": "N",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2008-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP1921112",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "R78479",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.