RUBY GODBOLT (NPI# 1134573728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134573728 |
| Entity Type | Individual |
| Full Name | RUBY GODBOLT |
| Practice Address |
9601 Pulaski Park Dr Suite 416 Baltimore MD 21220-1409 |
| Practice Telephone | 4109335678 |
| Practice Fax Number | 4102387451 |
| Mailing Telephone | 4109335678 |
| Mailing Fax Number | 4102387451 |
| Enumeration Date | 2016-04-20 |
| Last Update Date | 2016-07-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | R109843 | MD | Nursing Service Providers |
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
R109843 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
9601 PULASKI PARK DR SUITE 416 |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21220-1409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891778965 | Scott T Irrgang | Chiropractor | 9601 Pulaski Park Dr, Suite 416, Baltimore, MD 21220-1409 | 2005-11-22 |
| 1538607130 | Jeneba Lucia Charley | Registered Nurse | 9601 Pulaski Park Dr, Suite 417, Baltimore, MD 21220-1409 | 2017-02-03 |
| 1164974465 | Heidi Tripp | Registered Nurse | 9601 Pulaski Park Dr, Suite 417, Baltimore, MD 21220-1409 | 2016-11-02 |
| 1588027726 | Sharon Conner | Registered Nurse | 9601 Pulaski Park Dr, Suite 417, Baltimore, MD 21220-1409 | 2016-04-04 |
| 1366808669 | Doris Luck | Registered Nurse | 9601 Pulaski Park Dr, Suite 417, Baltimore, MD 21220-1409 | 2016-01-04 |
| 1124492558 | Omolewa Cole | Registered Nurse | 9601 Pulaski Park Dr, Suite 417, Baltimore, MD 21220-1409 | 2015-11-23 |
| 1457737637 | Booketha Eckles | Registered Nurse | 9601 Pulaski Park Dr, Suite 417, Baltimore, MD 21220-1409 | 2015-08-10 |
| 1861888901 | Angela Moeller | Registered Nurse | 9601 Pulaski Park Dr, Suite 417, Baltimore, MD 21220-1409 | 2015-04-15 |
| 1134515273 | Patricia Pappas | Registered Nurse | 9601 Pulaski Park Dr, Suite 417, Baltimore, MD 21220-1409 | 2015-04-15 |
| 1932592136 | Michelle Semple-king | Registered Nurse | 9601 Pulaski Park Dr, Suite 417, Baltimore, MD 21220-1409 | 2015-03-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881164119 | Sian Crosby | Speech-Language Pathologist | Glenmar Elementrary School, 9700 Community Drive, Middle River, MD 21220 | 2018-11-29 |
| 1336545029 | Andrea Tuck | Counselor | 24 Granny Smith Ct, Baltimore, MD 21220 | 2014-11-07 |
| 1356762959 | Johns Hopkins Hospital | General Acute Care Hospital | 11550 Crossroad Circle, Unit 606, Middle River, MD 21220 | 2013-12-27 |
| 1770693392 | Costco Wholesale Corporation | Pharmacy | 9919 Pulaski Hwy, Baltimore, MD 21220 | 2006-08-30 |
| 1255393344 | James Wallace Carpenter | Physician Assistant | 10 North Green St, Va Med Center Ward 6b, Baltimore, MD 21220 | 2006-04-04 |
| 1386624427 | Allen F Clowers | Family Medicine | 107 Beacon Road, Baltimore, MD 21220 | 2006-01-17 |
| 1306229794 | Dorcas Lwanga | Dietitian, Registered | 201 Ballard Ave, Middle River, MD 21220 | 2015-07-02 |
| 1437550761 | Eastern Avenue Dental, LLC | Dentist | 12412 Eastern Ave, Baltimore, MD 21220 | 2014-09-05 |
| 1366857617 | Suprina Kaur | Dentist | 12412 Eastern Ave, Middle River, MD 21220 | 2014-06-25 |
| 1316905227 | Chienyenwa E. Nwachinemere | Internal Medicine | 201 Ballard Ave, Middle River, MD 21220 | 2006-05-02 |
| Find all providers in zip 21220 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750920179 | Jecinta Chinyere Ogbennah | Nurse Practitioner | 6629 Aaron Mee Way, Baltimore, MD 21237-4337 | 2020-01-02 |
| 1578114229 | Carolina Delacruz | Nurse Practitioner | 5601 Loch Raven Blvd Bldg Center, Baltimore, MD 21239-2945 | 2019-09-24 |
| 1033620398 | Samson Olanrewaju Arigbamu | Nurse Practitioner | 4800 Seton Drive, Baltimore, Baltimore, MD 21215 | 2017-10-13 |
| 1548571417 | Nnene Ukoha | Nurse Practitioner | 6521 Redgate Cir, Baltimore, MD 21228-1146 | 2010-06-25 |
| 1861545881 | Jackie Lynn Jones | Nurse Practitioner | 6105 Pinehurst Rd, Baltimore, MD 21212-2547 | 2007-01-21 |
| 1275545980 | Elizabeth Layne Shadis | Nurse Practitioner | 1331 S Hanover St, Baltimore, MD 21230-4220 | 2006-08-12 |
| 1295712859 | Donna Marie Jason | Nurse Practitioner | 7920 Scotts Level Rd, Baltimore, MD 21208-2629 | 2005-12-26 |
| 1942205380 | Barbara Resnick | Nurse Practitioner | 830 W 40th St, Baltimore, MD 21211-2116 | 2005-06-14 |
| 1538703301 | Skylar Grace Dunklebarger | Nurse Practitioner | 4940 Eastern Ave, Baltimore, MD 21224-2735 | 2019-11-04 |
| 1861046567 | Rebecca Whitlock Grochowski | Nurse Practitioner | 301 Saint Paul Pl, Dept of Med, Baltimore, MD 21202-2165 | 2019-07-31 |
| Find all providers in BALTIMORE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.