Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kelly Ledoux Godwin, PA-C

Individual provider Physician Assistant · NPI 1285136093

Kelly Ledoux Godwin, PA-C is a Physician Assistant in Appleton, Wisconsin. Qualified in 2017, 9 years ago. Practices with Fayetteville Area Health Education Foundation Inc, a 28-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in North Carolina and Wisconsin.

Years since qualifying
9
Licensed in
NC, WI
In the registry since
2018
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

3925 N Gateway Dr
Appleton, WI 54913-7863
Phone: (920) 380-4999
Fax: (920) 380-4961
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1601 Owen Dr, Fayetteville, NC 28304-3425 — (910) 678-0100

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 8503 (WI)
Physician Assistant Taxonomy 363A00000X · Licence 0010-07941 (NC)

Record details

NPI number1285136093
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMarch 7, 2018
Last updated in NPPESOctober 3, 2025
Certification dateOctober 3, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Fayetteville Area Health Education Foundation Inc — 28 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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