DIANE RENE GODMAN (NPI# 1649237454) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649237454 |
| Entity Type | Individual |
| Full Name | DIANE RENE GODMAN |
| Credential | PA-C |
| Practice Address |
1970 Boulevard Salem VA 24153-6404 |
| Mailing Address |
1970 Roanoke Blvd Salem VA 24153-6404 |
| Practice Telephone | 5409822463 |
| Practice Fax Number | 5408553469 |
| Mailing Telephone | 5409822463 |
| Mailing Fax Number | 5408553469 |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2011-11-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
0110001198 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1970 BOULEVARD |
| City | SALEM |
| State | VA |
| Zip Code | 24153-6404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659332906 | Richard M Marencik | Pharmacist | 1970 Boulevard, Salem, VA 24153-6404 | 2006-03-28 |
| 1740230515 | Christopher Lloyd Lentz | Physician Assistant | 1970 Boulevard, Clinic 2, Salem, VA 24153 | 2006-05-11 |
| 1063460582 | Amando Valencia Esguerra | Pathology | 1970 Boulevard, Salem, VA 24153-6404 | 2006-05-05 |
| 1053378737 | Tamara Derrise Morton | Dietitian, Registered | 1970 Boulevard, Salem, VA 24153-6404 | 2006-04-27 |
| 1376509356 | Steven Joseph Lash | Psychologist | 1970 Boulevard, Vamc Psychology Service (116b1), Salem, VA 24153-6404 | 2006-04-26 |
| 1194781476 | Frank Frederick Tellian | Psychiatry & Neurology | 1970 Boulevard, Vamc - Mental Health Clinic - 116a6, Salem, VA 24153-6404 | 2006-04-25 |
| 1235192832 | Laura Derk Hart | Physician Assistant | 1970 Boulevard, Salem, VA 24153-6404 | 2006-04-07 |
| 1386606531 | Elizabeth Ann Pingle | Pharmacist | 1970 Boulevard, Salem, VA 24153-6404 | 2006-04-04 |
| 1144282633 | Rhonda Kay Fletcher | Social Worker | 1970 Boulevard, Salem, VA 24153-6404 | 2006-04-03 |
| 1871555367 | Gordon Mcdonald King | Pharmacist | 1970 Boulevard, Salem, VA 24153-6404 | 2006-04-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669001228 | Paul Mcguire | Student in an Organized Health Care Education/Training Program | 1906 Braeburn Drive Psychiatry Gme, Salem, VA 24153 | 2020-04-06 |
| 1386114965 | Dynamic Medical LLC | Clinical Medical Laboratory | 1201 Texas Street, Salem, VA 24153 | 2018-11-27 |
| 1134607898 | Renew Psychiatry Services | Psychiatry & Neurology | 177 Electric Rd, Salem, VA 24153 | 2018-08-03 |
| 1508304015 | Samantha Getz | Assisted Living Facility | 3706 Knollridge Rd., Salem, VA 24153 | 2017-02-03 |
| 1518409762 | Melissa Ward | Case Manager/Care Coordinator | 1380 Southside Dr, Suite 100, Salem, VA 24153 | 2016-11-04 |
| 1154729051 | Allison Marie Parry | Physician Assistant | 1336 W Main St., Salem, VA 24153 | 2014-12-09 |
| 1598199457 | Stacy Stanley | Occupational Therapy Assistant | 4812 Moore Rd, Salem, VA 24153 | 2013-08-28 |
| 1366888034 | Dolores Hager | Speech-Language Pathologist | 1851 Harrogate Dr, Salem, VA 24153 | 2013-05-21 |
| 1073850764 | Joel Aaron Nickerson | Specialist/Technologist | 400 Spartan Dr., Salem High School, Salem, VA 24153 | 2013-01-15 |
| 1023387271 | National Diabetic Medical Supply, LLC | Durable Medical Equipment & Medical Supplies | 2153 Apperson Drive, Salem, VA 24153 | 2011-12-16 |
| Find all providers in zip 24153 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285255851 | Darby Samantha Jalbert | Physician Assistant | 2480 Liberty St Ne Ste 110, Salem, OR 97301-8381 | 2020-05-05 |
| 1639614852 | Gregory Bull | Physician Assistant | 622 Fernwood Dr, Salem, VA 24153-2654 | 2016-12-24 |
| 1841648862 | Theron J Wiese | Physician Assistant | 1395 Commercial St Se, Salem, OR 97302-4205 | 2016-05-31 |
| 1922329697 | Charleen Ann Thorburn | Physician Assistant | 22 Keewaydin Dr, Salem, NH 03079-2839 | 2010-06-17 |
| 1316188006 | Judith A Mitchell | Physician Assistant | 4999 Skyline Rd. S., Salem, OR 97306 | 2009-03-10 |
| 1215912712 | Amy Gouley | Physician Assistant | 1793 13th St Se, Salem, OR 97302-2541 | 2005-12-07 |
| 1306827100 | William Earle Williams | Physician Assistant | 1233 Edgewater St Nw, Salem, OR 97304-4049 | 2005-11-08 |
| 1700485224 | Roderick Mao | Physician Assistant | 159 N Broadway, Salem, NH 03079-2136 | 2020-10-26 |
| 1447719752 | Christine Nicole Jeffries | Physician Assistant | 360 Church St Se, Salem, OR 97301-3796 | 2019-03-16 |
| 1265999338 | Brolin Johnson | Physician Assistant | 1793 13th St Se, Salem, OR 97302-2541 | 2019-02-26 |
| Find all providers in SALEM | ||||
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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.