Active NPI
Heather Mae Goddeau, LPN
- Licensed Practical Nurse
- Morrisonville, NY
National Provider Identifier
1972096303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 326662
- Practice address
- 2155 Route 22B
Morrisonville, NY 12962-3417 - Phone
- (518) 563-8000
- Fax
- (518) 561-3490
- NPI assigned
- Jun 11, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 326662 | NY | Primary |
Addresses
Primary practice location
2155 Route 22B
Morrisonville, NY 12962-3417
Mailing address
2155 Route 22B
Morrisonville, NY 12962-3417
Phone (518) 563-8000
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 326662 | NY | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528675200000",
"number": "1972096303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2155 ROUTE 22B",
"city": "MORRISONVILLE",
"state": "NY",
"postal_code": "129623417",
"telephone_number": "518-563-8000",
"fax_number": "518-561-3490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2155 ROUTE 22B",
"city": "MORRISONVILLE",
"state": "NY",
"postal_code": "129623417",
"telephone_number": "518-563-8000",
"fax_number": "518-561-3490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GODDEAU",
"first_name": "HEATHER",
"middle_name": "MAE",
"name_prefix": "Mrs.",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-11",
"last_updated": "2018-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NY",
"license": "326662",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Morrisonville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.