KELLY GODECKE (NPI# 1851788897) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851788897 |
| Entity Type | Individual |
| Full Name | KELLY GODECKE |
| Credential | M.D. |
| Practice Address |
501 S Chipeta Way Salt Lake City UT 84108-1222 |
| Practice Telephone | 4069252712 |
| Mailing Telephone | 4069252712 |
| Enumeration Date | 2015-04-16 |
| Last Update Date | 2016-09-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
10093895-8905 | UT | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
501 S CHIPETA WAY |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84108-1222 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558332353 | David L Moulton | Psychiatry & Neurology | 501 S Chipeta Way, Salt Lake City, UT 84108-1222 | 2006-01-30 |
| 1639798853 | Jade Burrell | Music Therapist | 501 S Chipeta Way, Salt Lake City, UT 84108-1222 | 2020-04-09 |
| 1104455724 | Matthew Torbenson | Student in an Organized Health Care Education/Training Program | 501 S Chipeta Way, Salt Lake City, UT 84108-1222 | 2020-04-06 |
| 1699304147 | William Alexander Bennion | Student in an Organized Health Care Education/Training Program | 501 S Chipeta Way, Salt Lake City, UT 84108-1222 | 2020-04-06 |
| 1104455872 | Taylor Crosby Blanding | Student in an Organized Health Care Education/Training Program | 501 S Chipeta Way, Salt Lake City, UT 84108-1222 | 2020-04-05 |
| 1730718875 | Harjit Kaur | Student in an Organized Health Care Education/Training Program | 501 S Chipeta Way, Salt Lake City, UT 84108-1222 | 2020-04-01 |
| 1235767369 | Zachary H Schwartz | Student in an Organized Health Care Education/Training Program | 501 S Chipeta Way, Salt Lake City, UT 84108-1222 | 2020-04-01 |
| 1336777937 | Giselle Mcintyre | Student in an Organized Health Care Education/Training Program | 501 S Chipeta Way, Salt Lake City, UT 84108-1222 | 2020-03-30 |
| 1578191144 | Margaux Barbara Miller | Student in an Organized Health Care Education/Training Program | 501 S Chipeta Way, Salt Lake City, UT 84108-1222 | 2020-03-30 |
| 1679101539 | Caitlin Marie Clark | Student in an Organized Health Care Education/Training Program | 501 S Chipeta Way, Salt Lake City, UT 84108-1222 | 2020-03-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548753056 | Maxine Ht Erickson | Assistant Behavior Analyst | 780 Guardsman Way, Salt Lake City, Ut 84108, Salt Lake City, USA 84108 | 2018-06-08 |
| 1841704061 | Robyn Carver | Occupational Therapist | 421 Wakara Wat, Salt Lake City, UT 84108 | 2017-11-27 |
| 1518478742 | Lcr Dental Sugar House | Dentist | 2068 S 2100 E Suite #a, Salt Lake City, UT 84108 | 2017-10-16 |
| 1447708912 | Aubrianne Squire Evans | Occupational Therapist | 421 S Wakara Way Ste 201, Salt Lake City, UT 84108 | 2016-09-14 |
| 1629524426 | Ryan Weisenbeck | Specialist/Technologist | 580 S Guardsman Way, Salt Lake City, UT 84108 | 2016-08-31 |
| 1164885547 | Michael Fazzone | Student in an Organized Health Care Education/Training Program | 530 South Wakara Way, University of Urah, School of Dentistry, Salt Lake City, UT 84108 | 2016-04-01 |
| 1669833489 | Bryon Claflin | Registered Nurse | 650 S Komas Ste 200, Salt Lake City, UT 84108 | 2016-03-08 |
| 1801283833 | Autism Assement Treatment Program Adult | Psychologist | 650 S Komas, Suite 200, Salt Lake City, UT 84108 | 2015-04-16 |
| 1578993275 | Matthew and David Dental Pllc | Dentist | 1355 Foothill Drive, Salt Lake City, UT 84108 | 2013-11-15 |
| 1841631520 | Deepika Garg | Internal Medicine | 675 S Arapeen Dr Ste 205, Salt Lake City, UT 84108 | 2013-07-10 |
| Find all providers in zip 84108 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811549637 | Nume Tms Utah, Pllc | Psychiatry & Neurology | 560 S 300 E Ste 115, Salt Lake City, UT 84111-3562 | 2019-07-11 |
| 1497288351 | Tyler Durns | Psychiatry & Neurology | 50 N Medical Dr Salt Lake City, Salt Lake City, UT 84132-0001 | 2017-04-07 |
| 1457705279 | Heather Wark | Psychiatry & Neurology | 3313 E Coronet Dr, Salt Lake City, UT 84124-3102 | 2016-04-18 |
| 1114311255 | Shane Verhoef | Psychiatry & Neurology | 500 Foothill Dr Bldg 16, Salt Lake City, UT 84148-1023 | 2015-03-26 |
| 1376947051 | University of Utah Behavioral Health Services | Psychiatry & Neurology | 30 N 1900 E Ste 1b620, Salt Lake City, UT 84132-0002 | 2014-10-09 |
| 1700120334 | R. Duncan Wallace, M.d., P.C. | Psychiatry & Neurology | 2972 S Devonshire Cir, Salt Lake City, UT 84108-2526 | 2012-11-20 |
| 1336407790 | Anthony Michael Petersen | Psychiatry & Neurology | University of Utah Psychiatry Department, 50 North Medical Drive, Salt Lake City, UT 84132-0001 | 2012-04-24 |
| 1982971826 | Robert Allan Weitzel | Psychiatry & Neurology | 78 U St, Salt Lake City, UT 84103-4304 | 2011-11-21 |
| 1427349042 | Kristen Leigh Pagel | Psychiatry & Neurology | 30 N 1900 E Rm 1c412, Gme Office, Salt Lake City, UT 84132-0002 | 2011-04-30 |
| 1952690919 | Brent Michael Kious | Psychiatry & Neurology | University Hospital 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2011-03-30 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84108 |
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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.