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Active NPI 1255617783 Individual Practitioner Female Practitioner

Lisa Goddard , APRN

Nurse Practitioner - Pediatrics • Largo, FL

Professional Overview & Biography Verified Profile Summary

Lisa Goddard, APRN is a registered healthcare professional specializing in Nurse Practitioner - Pediatrics in Largo, FL. Practice services are available at 1395 W BAY DR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1395 W Bay Dr

Largo, FL 337702205

Telephone 7275846802
Associated Practice Facility / Clinic
🏢 Haynes Milas Sterling Pa Facility NPI 1275578510

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner - Pediatrics in Largo, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.9 Yrs
Regional Practice Density
9 Specialists

Practicing in Largo, FL (1565 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-08-13
Nurse Practitioner - Pediatrics Primary Specialty

NUCC Taxonomy Code: 363LP0200X

State License FL APRN9327272

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
008881100 (FL)

Secondary Practice Locations

431 Southwest Blvd N

St Petersburg, FL 337031399

Phone: 7275267337

2370 Drew St Ste B

Clearwater, FL 337653318

Phone: 7274611543

1757 Ocoee Apopka Rd

Apopka, FL 327039263

Phone: 4072491234

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
NPI 1073563680

Doctor of Medicine (M.D.)

NPI 1235700337

Doctor of Medicine (M.D.)

NPI 1679523732

Doctor of Osteopathic Medicine (D.O.)

NPI 1790735553

Doctor of Medicine (M.D.)

NPI 1891745964

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

17 Historical Events
📍
Updated Practice Location August 13, 2024

Registered at 1395 W BAY DR, LARGO, FL 337702205 (Tel: 7275846802)

📍
Updated Business Mailing Address August 13, 2024

Registered at 5364 ELISEO ST, SARASOTA, FL 342384791 (Tel: 4078316200)

📍
Updated Practice Location October 23, 2023

Registered at 431 SOUTHWEST BLVD N, ST PETERSBURG, FL 337031399 (Tel: 7275267337)

📍
Updated Business Mailing Address June 28, 2021

Registered at 900 S PINE ISLAND RD STE 800, PLANTATION, FL 333243923 (Tel: 4078316200)

👤
Provider Name / Credentials Updated June 28, 2021

Recorded as LISA GODDARD, APRN

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 28, 2021

Nurse Practitioner (License #APRN9327272 in FL)

✅
NPI Profile Active January 09, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location January 09, 2018

Registered at 475 OSCEOLA ST STE 1100, ALTAMONTE SPRINGS, FL 327017857 (Tel: 4078316200)

📍
Updated Business Mailing Address January 09, 2018

Registered at 475 OSCEOLA ST STE 1100, ALTAMONTE SPRINGS, FL 327017857 (Tel: 4078316200)

👤
Provider Name / Credentials Updated January 09, 2018

Recorded as LISA GODDARD, CPNP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 09, 2018

Nurse Practitioner (License #ARNP9327272 in FL)

✅
NPI Profile Active October 28, 2011

NPI status registered as active in NPPES database

📍
Updated Practice Location October 28, 2011

Registered at 105 COMMERCE DR, BROCKWAY, MI 480973460 (Tel: 8103879612)

📍
Updated Business Mailing Address October 28, 2011

Registered at 3050 COMMERCE DR, SUITE B, FORT GRATIOT, MI 480593819 (Tel: 8103854441)

👤
Provider Name / Credentials Updated October 28, 2011

Recorded as LISA GODDARD, CPNP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 28, 2011

Nurse Practitioner (License #4704198684 in MI)

🟢
Initial NPI Registration & Enumeration October 28, 2011

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1255617783
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 28, 2011
Last Update: August 13, 2024
Sole Proprietor: No
Update or Correct Profile

Mailing Address

5364 Eliseo St

Sarasota, FL 342384791

Phone: 4078316200

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.