MEDICARE: SHANA GODFRED-CATO D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	81648	GA
2	207PP0204X	Pediatric Emergency Medicine (Emergency Medicine) Physician	81648	GA
3	208000000X	Pediatrics Physician	BP10043657	TX
4	208000000X	Pediatrics Physician	Q2552	TX
5	208000000X	Pediatrics Physician	13061138-1204	UT
6	208000000X	Pediatrics Physician	252626	AK
7	208M00000X	Hospitalist Physician	81648	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538429212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANA GODFRED-CATO D.O.

Provider Business Mailing Address
First Line	:	7033 E TUDOR RD
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99507-1262
Country	:	US
Telephone Number	:	907-729-8961
Fax Number	:	907-729-5180

Provider Business Practice Location Address
First Line	:	4320 DIPLOMACY DR
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5925
Country	:	US
Telephone Number	:	907-729-3300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2012
Last Update Date	:	06/10/2026

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Directions to “ SHANA GODFRED-CATO D.O.” Practice Location

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