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AMANDA VIOLET GRIPPEN GODDARD D.O. NPI 1710399654


NPI Information

NPI: 1710399654
Provider Name: AMANDA VIOLET GRIPPEN GODDARD, D.O.
Classification: Allergy & Immunology - 207K00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
7001 SIGNAL AVE NE
ALBUQUERQUE, NM
ZIP 87113
Phone: (505) 826-2735
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Amanda Violet Grippen Goddard, D.O. is an allergy immunology in Albuquerque, NM with 10 years of experience. The provider is an allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system. Amanda Violet Grippen Goddard, D.O. NPI is 1710399654. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

7001 SIGNAL AVE NE
ALBUQUERQUE, NM
ZIP 87113-453
Phone: (505) 826-2735
Fax: (505) 856-2749

The NPI 1710399654 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/27/2014 and was last updated on 10/30/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207K00000XAllergy & ImmunologyA233920NEW MEXICOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11D3719OTHERNEW MEXICOMEDICARE PTAN
238337207MEDICAIDNEW MEXICO
31D3721OTHERNEW MEXICOMEDICARE PTAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.