Individual provider Active NPI

Gayle Elizabeth Godfrey, RNBC

  • Psychiatric/Mental Health Registered Nurse
  • St. Paul, MN
National Provider Identifier
1992006126
Registry record updated Nov 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
R 105954-2 Issued in MN
Practice address
408 Saint Peter Ave.
429
St. Paul, MN 55102
Phone
(651) 224-0614
Fax
(651) 224-5754
NPI assigned
Nov 4, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Registered Nurse 163WG0600X R 105954-2 MN
Psychiatric/Mental Health Registered Nurse 163WP0808X R 105954-2 MN Primary

Addresses

Primary practice location

408 Saint Peter Ave.
429
St. Paul, MN 55102

Mailing address

6504 Warren Ave S
Edina, MN 55439-1247
Phone (651) 403-5005

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

LicenseStateTypeSpecialty
R 105954-2MNMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Hamm Psychiatric Clinic Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1288828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288828800000",
    "number": "1992006126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6504 WARREN AVE S",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554391247",
            "telephone_number": "651-403-5005",
            "fax_number": "651-224-5754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 SAINT PETER AVE.",
            "address_2": "429",
            "city": "ST. PAUL",
            "state": "MN",
            "postal_code": "55102",
            "telephone_number": "651-224-0614",
            "fax_number": "651-224-5754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODFREY",
        "first_name": "GAYLE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "RNBC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-04",
        "last_updated": "2010-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "MN",
            "license": "R 105954-2",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MN",
            "license": "R 105954-2",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St. Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2010; 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.