Individual provider Active NPI

Mandrea Jeanette Godsey, BSCD MHPP

  • Case Manager/Care Coordinator
  • Blytheville, AR
National Provider Identifier
1962619494
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
1510 Byrum Rd
Blytheville, AR 72315-8033
Phone
(870) 532-2600
Fax
(870) 532-8494
NPI assigned
May 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

1510 Byrum Rd
Blytheville, AR 72315-8033

Mailing address

802 Reams Ave
Gosnell, AR 72315-5719
Phone (870) 532-5953

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962619494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 REAMS AVE",
            "city": "GOSNELL",
            "state": "AR",
            "postal_code": "723155719",
            "telephone_number": "870-532-5953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 BYRUM RD",
            "city": "BLYTHEVILLE",
            "state": "AR",
            "postal_code": "723158033",
            "telephone_number": "870-532-2600",
            "fax_number": "870-532-8494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODSEY",
        "first_name": "MANDREA",
        "middle_name": "JEANETTE",
        "name_prefix": "Mrs.",
        "credential": "BSCD MHPP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blytheville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.