| Godwin Psychiatry P.a. | |
|
2719 Graves Drive #19 #19 Goldsboro NC 27534-4536 | |
| (919) 587-4051 | |
| (919) 580-1083 |
| Full Name | Godwin Psychiatry P.a. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2719 Graves Drive #19, Goldsboro, North Carolina |
| Authorized Official Name and Position | Meredith Owen Godwin (OWNER-PSYCHIATRIST) |
| Authorized Official Contact | 9195874051 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Godwin Psychiatry P.a. 2719 Graves Drive #19 #19 Goldsboro NC 27534-4536 Ph: (919) 587-4051 | Godwin Psychiatry P.a. 2719 Graves Drive #19 #19 Goldsboro NC 27534-4536 Ph: (919) 587-4051 |
| NPI Number | 1770213282 |
|---|---|
| Provider Enumeration Date | 06/16/2022 |
| Last Update Date | 10/17/2022 |
| Certification Date | 10/17/2022 |
| Medicare PECOS PAC ID | 9830574656 |
|---|---|
| Medicare Enrollment ID | O20220915000372 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770213282 | NPI | - | NPPES |
| 270174 | Other | NC | NORTH CAROLINA MEDICAL BOARD |
| 5913116 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Sharon C Mumford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619084035 PECOS PAC ID: 9335245562 Enrollment ID: I20070504000443 |
| Provider Name | Meredith O Godwin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659571792 PECOS PAC ID: 0244377869 Enrollment ID: I20091029000633 |
| Provider Name | Jennifer A Crandall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124776521 PECOS PAC ID: 1153799507 Enrollment ID: I20221116002235 |
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