Individual provider Active NPI

Rachel Elizabeth Godwin, CRNP

  • Family Nurse Practitioner
  • Dothan, AL
National Provider Identifier
1932937828
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-166247 Issued in AL
Practice address
1118 Ross Clark Cir Ste 402
Dothan, AL 36301-3002
Phone
(334) 673-3633
Fax
(334) 836-2894
NPI assigned
Jul 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-166247 AL Primary

Addresses

Primary practice location

1118 Ross Clark Cir Ste 402
Dothan, AL 36301-3002

Mailing address

1118 Ross Clark Cir Ste 402
Dothan, AL 36301-3002
Phone (334) 673-3633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20241108002941 AL Practitioner - Nurse Practitioner 1355875667 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dothan OBGYN, Inc.Group PAC ID 8022042076, 6 clinicians

Practice addresses (Care Compare)

1118 Ross Clark Cir
Suite 402
Dothan, AL 36301-3002
Phone (334) 673-3633

Hospital & facility affiliations

  • Southeast Health Medical Center Hospital, Dothan, AL, CCN 010001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-166247ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dothan OBGYN, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

1118 Ross Clark Cir
#402888888888888888888888888888888
Dothan, AL 36301

1118 Ross Clark Cir
Ste 402
Dothan, AL 36301
Phone (334) 673-3633

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1721692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1932937828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 ROSS CLARK CIR STE 402",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013002",
            "telephone_number": "334-673-3633",
            "fax_number": "334-836-2894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 ROSS CLARK CIR STE 402",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013002",
            "telephone_number": "334-673-3633",
            "fax_number": "334-836-2894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODWIN",
        "first_name": "RACHEL",
        "middle_name": "ELIZABETH",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-23",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-166247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.