NPI Code Detail JSON Logo

1154286201 NPI number — JEWEL GODDU

NPI Number: 1154286201
Health Care Provider/Practitioner: JEWEL GODDU

Information about “1154286201” NPI (JEWEL GODDU) exists in 1154286201 in HTML format HTML  |  1154286201 in plain Text format TXT  |  1154286201 in PDF (Portable Document Format) PDF  |  1154286201 in an XML format XML  formats.

NPI Number : 1154286201 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1154286201",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GODDU",
    "FirstName": "JEWEL",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "12 CUSHMAN ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ACUSHNET",
    "MailingAddressStateName": "MA",
    "MailingAddressPostalCode": "02743-2333",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1565 N MAIN ST STE 205",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FALL RIVER",
    "PracticeLocationAddressStateName": "MA",
    "PracticeLocationAddressPostalCode": "02720-2972",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "774-992-4981",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/22/2025",
    "LastUpdateDate": "12/22/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "106S00000X",
        "TaxonomyName": "Behavior Technician",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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