Individual provider Active NPI

Sheila Diane Goldsworthy, MD

  • Obstetrics & Gynecology Physician
  • Salem, OR
National Provider Identifier
1700872918
Registry record updated Mar 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD28499 Issued in OR
Practice address
2020 Capitol St NE
Salem, OR 97301-0644
Phone
(503) 399-2424
Fax
(503) 375-7528
NPI assigned
Sep 22, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD28499 OR Primary

Addresses

Primary practice location

2020 Capitol St NE
Salem, OR 97301-0644

Mailing address

2020 Capitol St NE
Salem, OR 97301-0644
Phone (503) 399-2424

Other identifiers 1

IdentifierTypeStateIssuer
100124890BMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080904000762 OR Practitioner - Obstetrics/Gynecology 9638135742 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salem Clinic PCGroup PAC ID 7517954514, 96 clinicians

Practice addresses (Care Compare)

2020 Capitol St NE
Salem, OR 97301-0644
Phone (503) 399-2424

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Clinic, PC CurrentSince Sep 2, 2008 Accepting new patients
Salem Health Past Accepting new patients
Stillwater Womens Clinic Inc PastSince Sep 1, 2004 Accepting new patients

Locations

2020 Capitol St NE
Salem, OR 97301
Phone (503) 399-2470

Interoperability endpoints

  • Direct secure messaging: sgoldsworthy38929@salemclinic.gardenplot.direct-ci.com

Organizations & group practices 3

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331510400000",
    "number": "1700872918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 CAPITOL ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973010644",
            "telephone_number": "503-399-2424",
            "fax_number": "503-375-7528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 CAPITOL ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973010644",
            "telephone_number": "503-399-2424",
            "fax_number": "503-375-7528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSWORTHY",
        "first_name": "SHEILA",
        "middle_name": "DIANE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-22",
        "last_updated": "2012-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OR",
            "license": "MD28499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100124890B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.