Active NPI
Rena R Godfrey, M.P.T.
- Physical Therapist
- Tacoma, WA
National Provider Identifier
1871698050
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT00005367
- Practice address
- 1901 S Cedar St Ste B1
Tacoma, WA 98405-2305 - Phone
- (253) 272-6910
- Fax
- (253) 383-4218
- NPI assigned
- Sep 13, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT00005367 | WA | Primary |
Addresses
Primary practice location
1901 S Cedar St Ste B1
Tacoma, WA 98405-2305
Mailing address
1519 132ND St SE
Suite a
Everett, WA 98208-7203
Phone (425) 357-9380
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GO9746 | Other | VA | PREMERA BLUE CROSS |
| P00286357 | Other | WA | RAILROAD MEDICARE |
| GO9746 | Other | WA | REGENCE BLUE SHIELD |
| 8341430 | Medicaid | WA | |
| 0197667 | Other | WA | DEPT OF LABOR & INDUSTRY |
| 0296931 | Other | WA | L & I |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT00005367 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346112000000",
"number": "1871698050",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1519 132ND ST SE",
"address_2": "SUITE A",
"city": "EVERETT",
"state": "WA",
"postal_code": "982087203",
"telephone_number": "425-357-9380",
"fax_number": "425-357-9382"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901 S CEDAR ST STE B1",
"city": "TACOMA",
"state": "WA",
"postal_code": "984052305",
"telephone_number": "253-272-6910",
"fax_number": "253-383-4218"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GODFREY",
"first_name": "RENA",
"middle_name": "R",
"credential": "M.P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-13",
"last_updated": "2012-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT00005367",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREMERA BLUE CROSS",
"identifier": "GO9746",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00286357",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD",
"identifier": "GO9746",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8341430",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF LABOR & INDUSTRY",
"identifier": "0197667",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L & I",
"identifier": "0296931",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.