Organization Active NPI

Carlos a Godoy M D P C

  • Cardiovascular Disease Physician
  • Livonia, MI
National Provider Identifier
1912298902
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
CG033015 Issued in MI
Legal business name
CARLOS A GODOY M D P C
Practice address
17920 Farmington Rd
Livonia, MI 48152-3104
Phone
(313) 909-1334
NPI assigned
Apr 25, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Authorized official

Name
Kelly Owens
Title
Credentialing
Phone
(734) 459-7444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X CG033015 MI Primary

Addresses

Primary practice location

17920 Farmington Rd
Livonia, MI 48152-3104

Mailing address

17920 Farmington Rd
Livonia, MI 48152-3104

National Provider Directory

National Provider Directory

Locations

14151 Greenfield Rd
Detroit, MI 48227
Phone (313) 836-6660

NPI Registry JSON

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

{
    "created_epoch": "1303689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529452800000",
    "number": "1912298902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17920 FARMINGTON RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481523104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17920 FARMINGTON RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481523104",
            "telephone_number": "313-909-1334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLOS A GODOY M D P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-25",
        "last_updated": "2018-06-20",
        "status": "A",
        "authorized_official_last_name": "OWENS",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "734-459-7444"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "CG033015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; 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.