Charles Brien Godfrey, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

26058 Issued in MN

Practice address

501 Highway 13 E
Suite 116
Burnsville, MN 55337-2884

Phone

(651) 365-3606

Fax

(651) 681-9317

NPI assigned

Dec 13, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Mental Health Resources, Inc.

  • Case Management Agency
  • Burnsville, MN
  • NPI 1376721589
  NPD (past)
• Mental Health Resources, Inc.

  • Case Management Agency
  • Saint Paul, MN
  • NPI 1538764774
  NPD (past)

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443052800000",
    "number": "1962563536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 HIGHWAY 13 E",
            "address_2": "SUITE 116",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553372884",
            "telephone_number": "651-365-3606",
            "fax_number": "651-681-9317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 HIGHWAY 13 E",
            "address_2": "SUITE 116",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553372884",
            "telephone_number": "651-365-3606",
            "fax_number": "651-681-9317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODFREY",
        "first_name": "CHARLES",
        "middle_name": "BRIEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2015-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MN",
            "license": "26058",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "26058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Global International LLC
• Jeff Glover, MA LADC
• Tishara Tinae Glover
• Brandi Gnade
• Elizabeth Jeanne Gockowski, MS, LPCC
• Ryan H Goeke, OT
• Angela A Goens
• Anna Goettl
• Leah Marie Gohman
• Golden Maple Homes, Inc.

• Psychiatry Physician in Burnsville, MN
• Providers in Burnsville, MN by specialty
• Psychiatry Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2015; 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.