DR. KENNETH THOMAS GOODELL (NPI# 1225164379) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225164379 |
| Entity Type | Individual |
| Full Name | DR. KENNETH THOMAS GOODELL |
| Credential | KEN GOODELL |
| Practice Address |
1515 Village Dr Emergency Department Cottage Grove OR 97424-9700 |
| Mailing Address |
Po Box 569 Eugene OR 97440-0569 |
| Practice Telephone | 5419420511 |
| Enumeration Date | 2007-02-25 |
| Last Update Date | 2012-09-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | DO150423 | OR | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639387467 | Kenneth Edward Goodell | Physical Therapy Assistant | 12401 Partridge Hill Row, Hudson, FL 34667-2328 | 2007-05-17 |
| Street Address |
1515 VILLAGE DR EMERGENCY DEPARTMENT |
| City | COTTAGE GROVE |
| State | OR |
| Zip Code | 97424-9700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972507952 | Paul J Steier | Family Medicine | 1515 Village Dr, Cottage Grove, OR 97424-9700 | 2005-06-08 |
| 1942781489 | Kimberly Rae Stober | Nurse Practitioner | 1515 Village Dr, Cottage Grove, OR 97424-9700 | 2018-08-23 |
| 1760961288 | Mckinley Marie Hutchison | Nurse Practitioner | 1515 Village Dr, Cottage Grove, OR 97424-9700 | 2018-08-07 |
| 1083064737 | Maria Jane Holder | Nurse Practitioner | 1515 Village Dr, Cottage Grove, OR 97424-9700 | 2016-06-14 |
| 1538538327 | Brandy Bump Zerby | Physician Assistant | 1515 Village Dr, Cottage Grove, OR 97424-9700 | 2015-09-22 |
| 1487044376 | Rebecca Mcbride | Nurse Practitioner | 1515 Village Dr, Cottage Grove, OR 97424-9700 | 2015-01-29 |
| 1023450715 | Peace Health | Non-Pharmacy Dispensing Site | 1515 Village Dr, Cottage Grove, OR 97424-9700 | 2013-07-23 |
| 1104266956 | Jonathan Rafael Javier Lazaro | Family Medicine | 1515 Village Dr, Cottage Grove, OR 97424-9700 | 2013-06-26 |
| 1043564586 | Ehsan Hazrat | Family Medicine | 1515 Village Dr, Cottage Grove, OR 97424-9700 | 2012-11-06 |
| 1477816908 | Julie Ann Alcantara Galinato | Family Medicine | 1515 Village Dr, Cottage Grove, OR 97424-9700 | 2012-06-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851936157 | Naomi Higgs | Physical Therapy Assistant | 515 Grant St, Cottage Grove, OR 97424 | 2019-11-10 |
| 1588131296 | Home Town Drugs of Cottage Grove, Inc. | Pharmacy | 1205 Hwy 99 North, Cottage Grove, OR 97424 | 2018-10-31 |
| 1215420625 | Zachary Booth | Student in an Organized Health Care Education/Training Program | 28188 Cottage Grove Lorane Rd, Cottage Grove, OR 97424 | 2018-06-11 |
| 1124404090 | Eileen Nittler | Social Worker | 1345 Birch Avenue, Cottage Grove, OR 97424 | 2015-08-03 |
| 1851799787 | Kathryn Brooks | Licensed Practical Nurse | 520 Patrick Loop, Cottage Grove, OR 97424 | 2014-12-09 |
| 1558767814 | Michele Renee Savage | Orthotic Fitter | 148 Gateway Blvd, Cottage Grove, OR 97424 | 2014-11-14 |
| 1730598558 | John Mansfield | Pharmacist | 120 Andrew Drive, Cottage Grove, OR 97424 | 2014-08-06 |
| 1700213493 | Aspen Injury Center LLC | Chiropractor | 1260 East Main Street, Cottage Grove, OR 97424 | 2013-09-26 |
| 1609172956 | Megan Olds | Counselor | 37 South 6th Street, Cottage Grove, OR 97424 | 2011-02-03 |
| 1144530726 | Monica G Radley | Counselor | 1345 Birch Ave., Cottage Grove, OR 97424 | 2010-10-15 |
| Find all providers in zip 97424 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750534079 | Erik Poyourow | Emergency Medicine | 1515 Village Dr, Cottage Grove, OR 97424-9700 | 2008-10-30 |
| 1306883087 | Daniel Kranitz | Emergency Medicine | 1515 Village Dr, Cottage Grove, OR 97424-9700 | 2006-06-01 |
| 1932170107 | Georgene Moldovan | Emergency Medicine | 1515 Village Dr, Cottage Grove, OR 97424-9700 | 2006-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043741010 | Hannah D Wolsiefer-leak | Emergency Medicine | 2826 East Barnett Rd, Medford, OR 97504-8332 | 2017-03-22 |
| 1366896581 | Collin Andrew Wulff | Emergency Medicine | 162 Ne Cloverdale Dr, Albany, OR 97321-1623 | 2016-04-14 |
| 1912361718 | Bryce Edwards | Emergency Medicine | 3181 Sw Sam Jackson Park Road, Ohsu, Portland, OR 97239 | 2016-04-07 |
| 1285013375 | Joseph Severo Simon | Emergency Medicine | 1200 Hilyard St Ste 310, Eugene, OR 97401-8122 | 2015-05-22 |
| 1073907978 | Karen Ta | Emergency Medicine | 10300 Se Main St, Portland, OR 97216 | 2015-03-27 |
| 1104210921 | Elizabeth Hatfield | Emergency Medicine | 3181 Sw Sam Jackson Park Rd # Cdw, Portland, OR 97239-3011 | 2015-03-19 |
| 1699171918 | Stephen Boyer | Emergency Medicine | 3708 Sw Lyle Ct, Portland, OR 97221-3963 | 2014-11-13 |
| 1679991590 | Meaghan Dehning | Emergency Medicine | 3181 Sw Sam Jackson Park Rd # Em, Portland, OR 97239-3011 | 2014-03-29 |
| 1760725485 | Deirdre Harmony Witte | Emergency Medicine | Salem Emergency Physicians, C/o Salem Hospital Ed, 890 Oak St, Se, Building A, Salem, OR 97301 | 2013-04-01 |
| 1164765293 | Joshua Starbuck Virgen Goldner | Emergency Medicine | 10180 Se Sunnyside Rd Dept Of, Clackamas, OR 97015-8970 | 2013-03-27 |
| Find all providers with the same taxonomy | ||||
| City | COTTAGE GROVE |
| Zip Code | 97424 |
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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.