Mary Godinich, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5689 Issued in OK

Practice address

11011 Hefner Pointe Dr Ste a
Oklahoma City, OK 73120-5005

Phone

(405) 479-8300

NPI assigned

Sep 26, 2024

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

Other names 1

• Mary Haugland Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Lakeside Pediatrics PC

  • Pediatrics Physician
  • Oklahoma City, OK
  • NPI 1184580532
  NPD (past)

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

{
    "created_epoch": "1727308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784073600000",
    "number": "1902624265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11011 HEFNER POINTE DR STE A",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731205005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11011 HEFNER POINTE DR STE A",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731205005",
            "telephone_number": "405-479-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODINICH",
        "first_name": "MARY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-26",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "5689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "HAUGLAND",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David Alan Goat, D.C.
• Ronald Clark Goat, D.C.
• Sheridan Christine Goble
• Shannon Godfrey, MOTR/L
• Mayra Godinez
• Mark T. Godish, M.D.
• Cali Godsson
• Kristina Ann Godwin, RN
• Kylie Joan Godwin
• Roslyn Godwin

• Physician Assistant in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; 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.