TERRY GOLDSWORTHY (NPI# 1376996140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376996140 |
| Entity Type | Individual |
| Full Name | TERRY GOLDSWORTHY |
| Credential | PEER SUPPORT |
| Practice Address |
1600 Nw Garden Valley Blvd Suite 110 Roseburg OR 97471-8700 |
| Practice Telephone | 5414403532 |
| Mailing Telephone | 5414403532 |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2016-07-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
1600 NW GARDEN VALLEY BLVD SUITE 110 |
| City | ROSEBURG |
| State | OR |
| Zip Code | 97471-8700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841805660 | Rae Ann Barnes | Pharmacist | 913 Ne Garden Valley Blvd, Pharmacy, Roseburg, OR 97471 | 2020-09-09 |
| 1023651031 | Colton Phillips | Behavioral Analyst | 940 Nw Garden Valley Bvld #104, Roseburg, OR 97471 | 2019-10-22 |
| 1952884876 | Meredith Krugel Lcsw PC | Clinic/Center | 2225 Nw Stewart Parkway Ste 200, Roseburg, OR 97471 | 2018-09-07 |
| 1114456563 | Philip Kaser Family, LLC | Pharmacy | 1175 W. Harvard Avenue, Roseburg, OR 97471 | 2017-06-08 |
| 1053854208 | Icco LLC | Clinic/Center | 1740 Nw Goetz Street, Roseburg, OR 97471 | 2016-11-21 |
| 1770034589 | Evie Jepsen | Case Manager/Care Coordinator | 2700 Stewart Parkway Annex B, Suite 110, Roseburg, OR 97471 | 2016-10-17 |
| 1932551256 | Jonathan Schmidt | Licensed Practical Nurse | 913 Nm Garden Valley Blvd, Va Roseburg Medical Center, Roseburg, OR 97471 | 2016-07-11 |
| 1932580586 | Jeffrey Mark Wareham | Case Manager/Care Coordinator | 2700 Medical Loop, Annex B, Roseburg, OR 97471 | 2015-06-09 |
| 1558784215 | Ginger Jean Thibedeau | Massage Therapist | 3019 Nw Stewart Parkway, Suite 304 #183, Roseburg, OR 97471 | 2014-01-30 |
| 1427303122 | Karishma Parekh | Internal Medicine | 2460 Nw Stewart Pkwy Ste 103, Roseburg, OR 97471 | 2012-07-18 |
| Find all providers in zip 97471 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699317230 | Zhana A Jacob | Peer Specialist | 1157 Nw Troost St, Roseburg, OR 97471-1896 | 2019-10-15 |
| 1093322919 | Natasha Ritson | Peer Specialist | 621 W Madrone St, Roseburg, OR 97470-3090 | 2020-09-24 |
| 1427664630 | Sara Clark | Peer Specialist | 621 W Madrone St, Roseburg, OR 97470-3090 | 2020-09-22 |
| 1396366902 | Hayden Ring | Peer Specialist | 621 W Madrone St, Roseburg, OR 97470-3090 | 2020-05-05 |
| 1790306314 | Sandra K Schafer-wisener | Peer Specialist | 621 W Madrone St, Roseburg, OR 97470-3090 | 2020-05-05 |
| 1720609332 | Jennifer Schaan | Peer Specialist | 621 W Madrone St, Roseburg, OR 97470-3090 | 2020-05-05 |
| 1063033280 | Crystal Mcavoy | Peer Specialist | 621 W Madrone St, Roseburg, OR 97470-3090 | 2020-04-28 |
| 1871128215 | Melrose Mona Ellan Mask | Peer Specialist | 621 W Madrone St, Roseburg, OR 97470-3090 | 2020-03-05 |
| 1801368022 | Dawnya Guyette | Peer Specialist | 621 W Madrone St, Roseburg, OR 97470-3090 | 2018-12-28 |
| 1477097681 | Viyanna Langager | Peer Specialist | 2700 Nw Stewart Pkwy, Roseburg, OR 97471-1281 | 2016-12-06 |
| Find all providers in ROSEBURG | ||||
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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.