Michael S Goddard

Primary specialty

PsychologistTaxonomy code 103T00000X

License

06675 Issued in MD

Practice address

1741 Ashland Ave
Baltimore, MD 21205-1531

Phone

(443) 923-7943

NPI assigned

Aug 14, 2021

Sex

Male

Sole proprietor

Yes

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

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Kennedy Krieger Associates

  • Pediatrics Physician
  • Baltimore, MD
  • NPI 1871515783
  Medicare reassignment NPD
• Kennedy Krieger Associates

  • Pediatrics Physician
  • Middle River, MD
  • NPI 1841009842
  NPD

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

{
    "created_epoch": "1628899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1861167413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1223 N CALVERT ST APT 2",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212021387",
            "telephone_number": "516-456-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1741 ASHLAND AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212051531",
            "telephone_number": "443-923-7943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODDARD",
        "first_name": "MICHAEL",
        "middle_name": "S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-14",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "06675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Marshall Gochnauer, MPT
• Christian Burris Gocke, M.D., PH.D.
• Christopher David Gocke, M.D.
• Nadine Godbolt
• Andrea Goddard, PSY.D
• Olena Goddard, MD
• Ryan Godek
• Mary Godfrey
• Miriam Flavia Godfrey, LCSW-C
• Rebecca J Godfrey, P.A.-C.

• Psychologist in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.