DR. JOHN D ROLL (NPI# 1891766911) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891766911 |
| Entity Type | Individual |
| Full Name | DR. JOHN D ROLL |
| Credential | MD |
| Practice Address |
9205 Sw Barnes Rd Portland OR 97225-6603 |
| Mailing Address |
9400 Sw Barnes Rd Suite 307 Portland OR 97225-6608 |
| Practice Telephone | 5032164830 |
| Practice Fax Number | 5032164850 |
| Mailing Telephone | 5032929108 |
| Mailing Fax Number | 5032920346 |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2007-07-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 24114 | OR | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 286240 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487022885 | John Roll | Clinical Nurse Specialist | 820 4th St N, Fargo, ND 58102-4539 | 2015-09-02 |
| Street Address |
9205 SW BARNES RD |
| City | PORTLAND |
| State | OR |
| Zip Code | 97225-6603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326041526 | Nate D Quilici | Specialist | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2005-05-23 |
| 1487251773 | Leah Burke Chapman | Nurse Practitioner | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2020-10-08 |
| 1366054819 | Jennifer Haas Pierron | Registered Nurse | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2020-08-17 |
| 1831717974 | Steffany Bixby | Dietitian, Registered | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2020-07-06 |
| 1477174076 | Nathaniel Edwards | Student in an Organized Health Care Education/Training Program | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2020-05-05 |
| 1801417407 | Karissa Kunihira | Student in an Organized Health Care Education/Training Program | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2020-05-05 |
| 1720609324 | Jakob Feeney | Student in an Organized Health Care Education/Training Program | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2020-05-05 |
| 1710508320 | Banu Ramachandran | Student in an Organized Health Care Education/Training Program | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2020-05-05 |
| 1083235964 | Amy Pohodich | Student in an Organized Health Care Education/Training Program | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2020-05-01 |
| 1740801620 | Steven C Freeman | Student in an Organized Health Care Education/Training Program | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2020-05-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508425034 | Gabrielle Gonzales | Behavior Technician | 1675 Sw Marlow Ave, Suite 200, Portland, OR 97225 | 2019-06-08 |
| 1558844555 | Tate Roseberry | Behavior Technician | 1675 Sw Marlow Avenue, Suite 200, Portland, OR 97225 | 2018-09-14 |
| 1982186300 | Dean Alan Hopkins | Registered Nurse | 11782 Sw Barnes Rd, Suite 300, Portland, OR 97225 | 2018-09-01 |
| 1316449168 | Surgery Center At St. Vincent, LLC | Clinic/Center | 9135 Sw Barnes Rd Ste 161, Portland, OR 97225 | 2018-03-07 |
| 1730606716 | Meghan Louise Lacy | Pediatrics | 11790 Sw Barnes Rd, Blg. A, Suite 140, Portland, OR 97225 | 2017-08-29 |
| 1841733433 | Tia Pugh | Occupational Therapist | 9155 S.w. Barnes Road, East Pavilion, Portland, OR 97225 | 2016-11-30 |
| 1295185585 | Stephanie Lynn Hart | Nurse Practitioner | 9155 Sw Barnes Rd Ste 240, Portland, OR 97225 | 2016-06-16 |
| 1962866244 | Bejian Shamloo | Chiropractor | 10200 Sw Eastridge St., Suite 235, Portland, OR 97225 | 2016-04-12 |
| 1992162630 | Robert Joseph Yoder | Psychologist | 9045 Barnes Rd, Portland, OR 97225 | 2016-01-26 |
| 1316303951 | Katie Herold | Chiropractor | 9315 Sw Morrison St, Portland, OR 97225 | 2016-01-12 |
| Find all providers in zip 97225 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215536560 | Irina A Mcgaughey | Specialist | 610 Sw Alder St Ste 920, Portland, OR 97205-3610 | 2020-10-19 |
| 1780294181 | Cynthia R Mendoza | Specialist | 2245 Se Powell Blvd, Portland, OR 97202-2143 | 2020-07-31 |
| 1679199335 | Alter Image, Inc. | Specialist | 2340 Se Gladstone St, Portland, OR 97202-2962 | 2020-06-18 |
| 1770044281 | Donnissa Smith | Specialist | 117 Se 129th Ave, Portland, OR 97233-1503 | 2019-03-27 |
| 1588191258 | Jason Moore | Specialist | 522 Ne Thompson St, Portland, OR 97212-3843 | 2017-05-12 |
| 1578097218 | Alicia N Keys | Specialist | 10480 Sw Eastridge St Apt 88, Portland, OR 97225-5047 | 2017-04-19 |
| 1942734736 | Mom By Lj | Specialist | 2906 N Willamette Blvd, Portland, OR 97217-4073 | 2017-04-18 |
| 1659811198 | Ricardo H. Medina | Specialist | 1400 Nw Irving St Apt 709, Portland, OR 97209-2260 | 2017-03-02 |
| 1730626805 | Jennifer Frank | Specialist | 1008 Se 112th Ave, Portland, OR 97216-3516 | 2017-01-26 |
| 1720523012 | Andrea Lett | Specialist | 4627 Ne 30th Ave, Portland, OR 97211-7001 | 2016-12-22 |
| 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.