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Kenneth Basil Godsey

Internal Medicine

Allopathic & Osteopathic Physicians

4708 Alliance Blvd Ste 300, Baylor Medical Plaza 1, Plano, TX 75093-5339

PECOS Enrollment

This provider is enrolled in PECOS as KENNETH GODSEY.

Based on the most recent information from CMS, provider Kenneth Basil Godsey is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1649384116
Provider Type
Individual
Full Name
Godsey, Kenneth Basil
Title
Dr.
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
8/19/2006
Last Updated
12/20/2022

Contact Information

Practice Location

4708 Alliance Blvd Ste 300, Baylor Medical Plaza 1, Plano, TX 75093-5339

(972) 758-6000

(972) 758-6001

Mailing Location

4708 Alliance Blvd Ste 300, Baylor Medical Plaza 1, Plano, TX 75093-5339

(972) 758-6000

(972) 758-6001

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License H1774 Texas

Provider Identifiers

ID	Description	Issuer
ID 0980039-03	Description Medicaid	Issuer Unlisted Texas
ID 010054856	Description Other	Issuer RR MEDICARE Texas

Kenneth Basil Godsey

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

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Stone, Selma Roxanne

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