Individual provider Active NPI

Cora M Goldberg

  • Athletic Trainer
  • Newark, DE
National Provider Identifier
1083236897
Registry record updated May 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
J3-0000434 Issued in DE
Practice address
1096 Old Churchmans Rd
Newark, DE 19713-2102
Phone
(302) 655-9494
NPI assigned
May 14, 2020
Last updated
May 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X RT005354 PA
Athletic Trainer 2255A2300X J3-0000434 DE Primary

Addresses

Primary practice location

1096 Old Churchmans Rd
Newark, DE 19713-2102

Mailing address

101 W Harmony Rd
West Grove, PA 19390-1013
Phone (610) 906-5155

Other practice location 1

101 W Harmony Rd
West Grove, PA 19390-1013
Phone (610) 906-5155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
J3-0000434DEMDAthletic Trainer
RT005354PAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1589414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589414400000",
    "number": "1083236897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W HARMONY RD",
            "city": "WEST GROVE",
            "state": "PA",
            "postal_code": "193901013",
            "telephone_number": "610-906-5155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1096 OLD CHURCHMANS RD",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132102",
            "telephone_number": "302-655-9494"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 W Harmony Rd",
            "address_purpose": "LOCATION",
            "city": "West Grove",
            "state": "PA",
            "postal_code": "193901013",
            "country_code": "US",
            "telephone_number": "610-906-5155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "CORA",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-14",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT005354",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "DE",
            "license": "J3-0000434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.