NATHANIEL ROBERTS JR. (NPI# 1174777494) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174777494 |
| Entity Type | Individual |
| Full Name | NATHANIEL ROBERTS JR. |
| Practice Address |
9268 Se Clinton St Portland OR 97266-1456 |
| Mailing Address |
Po Box 8459 Portland OR 97207-8459 |
| Practice Telephone | 5038729664 |
| Mailing Telephone | 5032380769 |
| Enumeration Date | 2008-11-13 |
| Last Update Date | 2008-11-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043655384 | Nathaniel Drew Roberts | Chiropractor | 2739 S 5600 W, Ste 170, West Valley, UT 84120-6091 | 2013-04-30 |
| 1760581953 | Nathaniel Surendranath Roberts | Pharmacist | Roosevelt Rd.&5th Ave, Hines, IL 60141 | 2006-09-22 |
| 1780834713 | Nathaniel Roberts | Nurse's Aide | 2250 Hickory Rd Ste 240, Plymouth Meeting, PA 19462-2225 | 2008-09-26 |
| 1841419231 | Nathaniel Jolo Roberts | Pharmacist | Walter Reed National Military Ctr, 8901 Wisconsin Ave, Bethesda, MD 20889-0001 | 2007-04-24 |
| Street Address |
9268 SE CLINTON ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97266-1456 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083768592 | Bruce A. Preston | Counselor | 9268 Se Clinton St, Portland, OR 97266-1456 | 2007-01-22 |
| 1659507937 | Megan Irby | Case Manager/Care Coordinator | 9268 Se Clinton St, Portland, OR 97266-1456 | 2009-06-01 |
| 1184850455 | Simon Williams | Counselor | 9268 Se Clinton St, Portland, OR 97266-1456 | 2009-06-01 |
| 1598915902 | Christie Ann Fry | Adult Companion | 9268 Se Clinton St, Portland, OR 97266-1456 | 2008-09-22 |
| 1447444062 | John Jay Goodman | Student in an Organized Health Care Education/Training Program | 9268 Se Clinton St, Portland, OR 97266-1456 | 2007-08-28 |
| 1932230653 | Jala Akilah Waleed | Counselor | 9268 Se Clinton St, Portland, OR 97266-1456 | 2007-03-07 |
| 1497899421 | Eric Reed Snow | Counselor | 9268 Se Clinton St, 2100 Se Belmont, Portland, OR 97266-1456 | 2007-02-15 |
| 1801939707 | Rebecca Leigh Rainy | Counselor | 9268 Se Clinton St, Portland, OR 97266-1456 | 2007-02-14 |
| 1689714958 | Stephen Patrick O'sullivan | Counselor | 9268 Se Clinton St, Portland, OR 97266-1456 | 2007-02-07 |
| 1497894075 | Richard R. Roell | Social Worker | 9268 Se Clinton St, Portland, OR 97266-1456 | 2007-02-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528545969 | Willamette Pharmacy | Pharmacy | 10209 Se Division Build B Ste 100, Portland, OR 97266 | 2018-07-27 |
| 1992204697 | Sober Living Oregon Treatment Center | Clinic/Center | 10209 Se Division, Portland, OR 97266 | 2018-02-08 |
| 1699204024 | Malori Christine Butler | Registered Nurse | 7335 Se 85th Ave., Portland, OR 97266 | 2017-06-08 |
| 1487028882 | Emil Kunkel | Naturopath | 6318 Se 87th Ave, Portland, OR 97266 | 2015-11-23 |
| 1194195313 | Cory Hall-martin | Counselor | 10011 Se Division St #305, Portland, OR 97266 | 2015-09-30 |
| 1336517721 | Krispin Mayfield | Counselor | 10011 Se Division St., Suite 203, Portland, OR 97266 | 2015-09-02 |
| 1407247927 | Syrena Nicholson | Community Health Worker | 7721 Se 92nd Avenue, Apt K, Portland, OR 97266 | 2015-02-06 |
| 1659777886 | Berhanu Aynalem Mekbib | Adult Companion | 9125 Sw 55th, El Dorado, Portland, OR 97266 | 2014-11-17 |
| 1871930685 | Felicitas Amelia Penaloza | Behavioral Analyst | 9911 Se Mt.scott Boulevard, Portland, OR 97266 | 2013-06-03 |
| 1710237326 | Janna Renee Higgins | Case Manager/Care Coordinator | 9911 Se Mt. Scott Boulevard, Portland, OR 97266 | 2012-09-12 |
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| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437775558 | John Alan Varner | Case Manager/Care Coordinator | 5833 N Lombard St, Portland, OR 97203-4115 | 2020-06-24 |
| 1750906228 | Dwell Care LLC. | Case Manager/Care Coordinator | 1720 Nw Lovejoy St Ste 202, Portland, OR 97209-2341 | 2020-06-10 |
| 1871138453 | Kedrick Starr | Case Manager/Care Coordinator | 14600 Nw Cornell Rd., Portland, OR 97229 | 2019-11-07 |
| 1477102077 | Joslyn Bailey Gheen | Case Manager/Care Coordinator | 1032 Sw Main St, Portland, OR 97205-2407 | 2019-09-05 |
| 1497311773 | Ali Tareq Ashour | Case Manager/Care Coordinator | 980 Forest Ave Ste 106, Portland, ME 04103-3357 | 2019-05-13 |
| 1427540202 | Amber Tracy Ware | Case Manager/Care Coordinator | 30 Ne Martin Luther King Jr Blvd, Portland, OR 97232-2941 | 2018-06-06 |
| 1710479209 | Katherine Anne Kerr | Case Manager/Care Coordinator | 4307 Ne 102nd Ave, Portland, OR 97220-3439 | 2018-05-31 |
| 1194230664 | Ankita Guchait | Case Manager/Care Coordinator | 14600 Nw Cornell Rd, Portland, OR 97229 | 2017-12-06 |
| 1083137459 | David Sague | Case Manager/Care Coordinator | 7820 Ne Holman St Ste B5, Portland, OR 97218-2841 | 2017-07-18 |
| 1538601885 | Gabriela Simone Sargent | Case Manager/Care Coordinator | 4109 Se 113th Ave, Portland, OR 97266-2226 | 2016-11-16 |
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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.