Physician Compare National (NPI:1386823813)

HEALTHCARE PROVIDER: NICOLE CARMEN GODETT PT

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1386823813
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7012204670
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160926000464
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GODETT
	Individual professional last name
Provider First Name	NICOLE
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2007
	Individual professional's medical school graduation year
Primary Specialty	PHYSICAL THERAPY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	901 N HERITAGE DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 106
	Group Practice or individual's line 2 address
City	RIDGECREST
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	935555541
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7603015411
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y