Individual provider Active NPI

Jill Susan Goldberg, D.C.

  • Chiropractor
  • Seattle, WA
National Provider Identifier
1801935689
Registry record updated May 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00033732 Issued in WA
Practice address
535 Pontius Ave N
Suite 124
Seattle, WA 98109-5547
Phone
(206) 405-3333
NPI assigned
Feb 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2013

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2013 MA
Chiropractor 111N00000X 01700 MD
Chiropractor 111N00000X CH00033732 WA Primary
Chiropractor 111N00000X 011513-1 NY

Addresses

Primary practice location

535 Pontius Ave N
Suite 124
Seattle, WA 98109-5547

Mailing address

535 Pontius Ave N
Suite 124
Seattle, WA 98109-5547
Phone (206) 405-3333

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2013MAMDAddiction (Substance Use Disorder) Counselor
011513NYMDMental Health Counselor
01700MDMDChiropractor
CH00033732WAMDChiropractor
011513-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cary Family Chiropractic, PLLC Chiropractor Current Accepting new patients
Milford Family Chiropractic LLC Chiropractor PastSince Apr 9, 2012 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369267200000",
    "number": "1801935689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 PONTIUS AVE N",
            "address_2": "SUITE 124",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981095547",
            "telephone_number": "206-405-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 PONTIUS AVE N",
            "address_2": "SUITE 124",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981095547",
            "telephone_number": "206-405-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "JILL",
        "middle_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2013-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "2013",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "01700",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00033732",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "011513-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2013; 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.