Active NPI
Shonna Rae Goldmann
- Skilled Nursing Facility
- Portland, OR
National Provider Identifier
1205096765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 1065169
- Practice address
- 10220 SW Greenburg Rd
Lincoln Center 3, Suite 201
Portland, OR 97223-5503 - Phone
- (888) 757-3422
- NPI assigned
- Jun 9, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 1065169 | OR | Primary |
Addresses
Primary practice location
10220 SW Greenburg Rd
Lincoln Center 3, Suite 201
Portland, OR 97223-5503
Mailing address
502 S 11TH St
Bismarck, ND 58504-5831
Phone (971) 235-1828
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1065169 | OR | MD | Skilled Nursing Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212969600000",
"number": "1205096765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "502 S 11TH ST",
"city": "BISMARCK",
"state": "ND",
"postal_code": "585045831",
"telephone_number": "971-235-1828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10220 SW GREENBURG RD",
"address_2": "LINCOLN CENTER 3, SUITE 201",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972235503",
"telephone_number": "888-757-3422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDMANN",
"first_name": "SHONNA",
"middle_name": "RAE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-09",
"last_updated": "2008-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "OR",
"license": "1065169",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.