Individual provider Active NPI

Kandace Michelle Goins, RN

  • Registered Nurse
  • Portland, OR
National Provider Identifier
1891069803
Registry record updated Mar 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
201041302RN Issued in OR
Practice address
722 NE 162ND Ave
Portland, OR 97230-5760
Phone
(503) 408-5016
NPI assigned
Mar 8, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 201041302RN OR Primary

Addresses

Primary practice location

722 NE 162ND Ave
Portland, OR 97230-5760

Mailing address

9830 NE Cascades Pkwy Ste 200
Portland, OR 97220-6834
Phone (503) 262-0145

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
201041302RNORMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Albertina Kerr Past Accepting new patients

Organizations & group practices 1

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": "1331164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331164800000",
    "number": "1891069803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9830 NE CASCADES PKWY STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972206834",
            "telephone_number": "503-262-0145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 NE 162ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972305760",
            "telephone_number": "503-408-5016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOINS",
        "first_name": "KANDACE",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-08",
        "last_updated": "2012-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201041302RN",
            "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 Mar 8, 2012; 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.