DEIDRE GOLDBERG (NPI# 1407844525) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407844525 |
| Entity Type | Individual |
| Full Name | DEIDRE GOLDBERG |
| Credential | FNP |
| Practice Address |
1698 E Mcandrews Rd Ste 300 Medford OR 97504-5589 |
| Mailing Address |
Po Box 3158 Portland OR 97208-3158 |
| Practice Telephone | 5417327850 |
| Practice Fax Number | 5417327851 |
| Mailing Telephone | 5417327850 |
| Mailing Fax Number | 5417327851 |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2015-02-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 82022347 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 009238 | 05 |
| Street Address |
1698 E MCANDREWS RD STE 300 |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-5589 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063963106 | Providence Health & Services - Oregon | Clinic/Center | 1698 E Mcandrews Rd, Ste 300, Medford, OR 97504-5589 | 2016-10-24 |
| 1992254080 | Yadira Amaral | Community Health Worker | 1698 E Mcandrews Rd, Ste 170, Medford, OR 97504-5589 | 2016-09-29 |
| 1841674173 | Judy Wong | Pharmacist | 1698 E Mcandrews Rd, Suite 400, Medford, OR 97504-5589 | 2015-07-16 |
| 1669870432 | Ashley Auspelmyer | Physician Assistant | 1698 E Mcandrews Rd, Providence Plaza, Suite 280, Medford, OR 97504-5589 | 2014-12-10 |
| 1801292107 | Sara G Hoppe | Physician Assistant | 1698 E Mcandrews Rd, Ste 160, Medford, OR 97504-5589 | 2014-11-13 |
| 1669609954 | Susan Bernier Martin | Registered Nurse | 1698 E Mcandrews Rd, Suite 170, Medford, OR 97504-5589 | 2009-06-15 |
| 1457517849 | Vivian Nkem Chidi | Internal Medicine | 1698 E Mcandrews Rd, Ste 170, Medford, OR 97504-5589 | 2008-08-05 |
| 1659530442 | Kadi-ann Bryan | Urology | 1698 E Mcandrews Rd, Suite 280, Medford, OR 97504-5589 | 2008-06-05 |
| 1679761944 | Skin Cncr & Ent Center | Specialist | 1698 E Mcandrews Rd, Suite 220, Medford, OR 97504-5589 | 2007-10-11 |
| 1316131279 | Wie-peng Kuo | Surgery | 1698 E Mcandrews Rd, Suite 160, Medford, OR 97504-5589 | 2007-09-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225673833 | Lydia D Sneed | Behavioral Analyst | 3707 Citation Way, Suite 102, Medford, OR 97504 | 2019-11-07 |
| 1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
| 1255809109 | Justin Blasdel | Technician, Health Information | 3250 Lone Pine Rd, Medford, OR 97504 | 2018-11-08 |
| 1396220133 | Aimee K Michel | Massage Therapist | 3550 National Dr., Medford, OR 97504 | 2018-09-27 |
| 1437646908 | Zola Dental Medford LLC | Dentist | 922 E Main, Medford, OR 97504 | 2018-04-19 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1023547536 | Joshua Morgan Rice | Dentist | 1117 E Main St Ste 1, Medford, OR 97504 | 2017-06-08 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1811443542 | Taya Adams | Doula | 1201 Progress Dr #90, Medford, OR 97504 | 2016-09-01 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| Find all providers in zip 97504 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689280620 | Danna Rae Morgan | Nurse Practitioner | 539 N Barneburg Rd, Medford, OR 97504-6678 | 2020-09-16 |
| 1609406164 | Andey Amata-kynvi | Nurse Practitioner | 99 Jerome St, Medford, MA 02155-6736 | 2020-01-23 |
| 1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
| 1215406459 | Natalia Eltabaa | Nurse Practitioner | 143b Atsion Rd, Medford, NJ 08055 | 2018-11-16 |
| 1922542489 | Genevieve Lumsden | Nurse Practitioner | 30 Auburn St, Medford, MA 02155-3623 | 2016-12-16 |
| 1821456708 | Sonia Nerteley Nettey | Nurse Practitioner | 86 Otis St Unit 2, Medford, MA 02155-4031 | 2016-02-05 |
| 1740532480 | Shannon Henderson | Nurse Practitioner | 520 Medical Center Dr Ste 201, Medford, OR 97504-4334 | 2012-10-04 |
| 1548577307 | Elaina S Jensen | Nurse Practitioner | 2385 Table Rock Rd # 103, Medford, OR 97501-1510 | 2010-08-31 |
| 1891928495 | Roberta Marie Bell | Nurse Practitioner | 617 Palm St, Medford, OR 97501 | 2009-08-29 |
| 1750567129 | Robert Anthony Kiesecker Jr. | Nurse Practitioner | 781 Black Oak Dr Ste 102, Medford, OR 97504-9501 | 2008-01-16 |
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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.