DR. KENNETH CHARLES GOLDBERG (NPI# 1457669673) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457669673 |
| Entity Type | Individual |
| Full Name | DR. KENNETH CHARLES GOLDBERG |
| Credential | MD |
| Practice Address |
407 Ne 12th Ave Ste 200 Portland OR 97232 |
| Practice Telephone | 5032800880 |
| Practice Fax Number | 5032327440 |
| Mailing Telephone | 5032800880 |
| Mailing Fax Number | 5032327440 |
| Enumeration Date | 2010-09-22 |
| Last Update Date | 2010-09-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083P0901X |
Preventive Medicine Specialization: Public Health & General Preventive Medicine |
MD16086 | OR | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992924575 | Kenneth Lester Goldberg | Dentist | 541 Anderson Ave, Cliffside Park, NJ 07010-1722 | 2007-04-24 |
| 1356465793 | Kenneth W Goldberg | Internal Medicine | 3590 W 9000 S Ste 240, West Jordan, UT 84088-8864 | 2007-03-19 |
| 1598867616 | Kenneth Allen Goldberg | Urology | 541 W Main St Ste 150, Lewisville, TX 75057-3666 | 2006-09-01 |
| 1336104512 | Kenneth J Goldberg | Psychologist | 600 E Baseline Rd, Suite C-1, Tempe, AZ 85283-1247 | 2006-04-19 |
| 1770992547 | Kenneth Goldberg | Psychologist | 215 Highland Ave, Suite C, Haddon Township, NJ 08108-2634 | 2014-08-06 |
| 1437200680 | Kenneth B Goldberg | Clinical Neuropsychologist | 1650 Huntingdon Pike, Meadowbrook, PA 19046-8004 | 2007-01-15 |
| 1366592099 | Kenneth David Goldberg | Dentist | 198 Main Street, Kingston, MA 02364-1928 | 2007-01-12 |
| 1598856585 | Kenneth Charles Goldberg | Internal Medicine | 508 Fulton St, Box 11c, Durham, NC 27705-3875 | 2006-09-27 |
| 1265451603 | Kenneth N Goldberg | Radiology | 2650 Ridge Ave, Department of Radiology, G507, Evanston, IL 60201-1718 | 2006-07-18 |
| 1326036120 | Kenneth M Goldberg | Dentist | 94 Brick Rd, West Jersey Medical Plaza Suite 100, Marlton, NJ 08053-2179 | 2005-10-06 |
| Street Address |
407 NE 12TH AVE STE 200 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97232 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689642381 | Kenneth Thomas Murphy | Chiropractor | 407 Ne 12th Ave, Ste. 203, Portland, OR 97232-2717 | 2006-03-09 |
| 1982040093 | Katja Biesanz | Counselor | 407 Ne 12th Ave, #201, Portland, OR 97232-2752 | 2013-05-15 |
| 1326311309 | Peter Gold | Counselor | 407 Ne 12th Ave, Suite 207, Portland, OR 97232-2752 | 2012-02-21 |
| 1831496876 | Raymond Howlorn Diaz | Naturopath | 407 Ne 12th Ave, Suite 100, Portland, OR 97232-2752 | 2011-02-25 |
| 1336381565 | Shannon Pernetti | Psychoanalyst | 407 Ne 12th Ave, Suite 101, Portland, OR 97232 | 2009-04-02 |
| 1578662979 | Moxie Body P C | Clinic/Center | 407 Ne 12th Ave, Suite 102, Portland, OR 97232-2752 | 2006-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881293215 | Oregon Change Clinic | Clinic/Center | 650 Ne Holladay Street, Suite 1600, Portland, OR 97232 | 2020-10-17 |
| 1154969947 | Lori Kristen Miracle | Acupuncturist | Kwan Yin Healing Arts Center East Inc, 3115 Ne Sandy Blvd. Suite 231, Portland, OR 97232 | 2019-12-12 |
| 1194285411 | Onampai Modina Soondarotok | Student in an Organized Health Care Education/Training Program | Ipp, Oregon Health & Science University, 2214 Lloyd Center, Portland, OR 97232 | 2019-03-22 |
| 1003399635 | Cathleen Nicole Wenberg | Social Worker | 1839 Ne Couch St, Portland, OR 97232 | 2018-09-10 |
| 1508350760 | Float North | Acupuncturist | 1617 Ne 17th Ave., Portland, OR 97232 | 2018-06-20 |
| 1629560719 | Rachael Lee Walters | Doula | 3005 Ne Hoyt St, Portland, OR 97232 | 2018-06-04 |
| 1225529431 | Jason Sutherland | Social Worker | 707 Ne Couch, Portland, OR 97232 | 2018-05-23 |
| 1770089245 | Richard Farwell Leman | Family Medicine | 800 Ne Oregon St., Suite 772, Portland, OR 97232 | 2018-04-03 |
| 1952803413 | Aleksandra Giedowyn Md PC | Family Medicine | 1923 Ne Broadway Street Suite 2, Portland, OR 97232 | 2018-03-01 |
| 1639680374 | Amanda Matteo | Counselor | 20 Ne 10th Ave, Portland, OR 97232 | 2017-10-20 |
| Find all providers in zip 97232 | ||||
| Taxonomy Code | 2083P0901X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Public Health & General Preventive Medicine |
| Public health and general preventive medicine focuses on promoting health, preventing disease, and managing the health of communities and defined populations. These practitioners combine population-based public health skills with knowledge of primary, secondary, and tertiary prevention-oriented clinical practice in a wide variety of settings. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. American Osteopathic Board of Preventive Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689020968 | James Anthony Gaudino Jr. | Preventive Medicine | 9061 Sw 38th Ave, Portland, OR 97219-5382 | 2016-05-05 |
| 1467833012 | Beth Hirschfield | Preventive Medicine | 3916 Sw Nevada Ct, Portland, OR 97219-1514 | 2015-06-09 |
| 1568664829 | Andrea Girman | Preventive Medicine | 1905 Ne Wygant St, Portland, OR 97211-5865 | 2007-05-31 |
| 1215153234 | Geoffrey Enochs Beasley | Preventive Medicine | 3181 Sw Sw Sam Jackson Park Rd., Portland, OR 97219 | 2007-04-18 |
| 1770707606 | Alan Norton Weiner | Preventive Medicine | 4 Milk St, Portland, ME 04101-4164 | 2007-04-12 |
| 1689713539 | Jay David Kravitz | Preventive Medicine | 14323 Nw Skyline Blvd, Portland, OR 97231-2403 | 2007-02-06 |
| 1245871110 | Passport Health Holdings, LLC | Preventive Medicine | 22 Monument Square, Suite 507, Portland, ME 04101-4031 | 2019-10-02 |
| 1740607985 | Bernadette Zakher | Preventive Medicine | 3181 Sw Sam Jackson Park Rd, Ohsu, Portland, OR 97239-3011 | 2014-03-26 |
| 1407287147 | Healthcare Naturally | Preventive Medicine | 3719 N Williams Ave, Portland, OR 97227-1440 | 2013-12-05 |
| 1992065882 | Evelyn Patricia Whitlock | Preventive Medicine | 3800 N Interstate Ave, Portland, OR 97227-1110 | 2012-05-24 |
| Find all providers in PORTLAND | ||||
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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.