John Ellis Gobble, DRPH, RD, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

000543 Issued in OR

Practice address

6542 SE Lake Rd Ste 202C
Milwaukie, OR 97222-2244

Phone

(503) 652-5070

Fax

(800) 957-1067

NPI assigned

Jun 1, 2005

Last updated

Nov 27, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR, WA2 enrollments

Enrollment records 2

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Gobble Shults and Associates IncGroup PAC ID 4587759436, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e
• WA PPO C-SNP

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gobble Shults & Associates Inc

  dba Lifestyle Medicine Group

  • Registered Dietitian
  • Milwaukie, OR
  • NPI 1275604399

  Dietitian, Registered, WA

  Medicare reassignment Care Compare group NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1013919323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1463 SW 20TH CT",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970809662",
            "telephone_number": "503-652-5070",
            "fax_number": "503-652-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6542 SE LAKE RD STE 202C",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972222244",
            "telephone_number": "503-652-5070",
            "fax_number": "800-957-1067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOBBLE",
        "first_name": "JOHN",
        "middle_name": "ELLIS",
        "name_prefix": "Dr.",
        "credential": "DRPH, RD, LD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "000543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500641681",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brooke Glendenning, RN
• Anya Glenn, MA, QMHP
• Patricia L Glynn, PTA
• Jeffrey Cama Go, PT
• Gobble Shults & Associates Inc (Lifestyle Medicine Group)
• Getachew Abule Godebo
• Andrew Godzyk, DMD
• Edward Keim Goering, D.O.
• Julie Goggin, SPEECH LANGUAGE PATH
• Alesha Goldhammer

• Registered Dietitian in Milwaukie, OR
• Providers in Milwaukie, OR by specialty
• Registered Dietitian in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.