MITALIBEN RAJENDRAKUMAR GOR (NPI# 1114564630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114564630 |
| Entity Type | Individual |
| Full Name | MITALIBEN RAJENDRAKUMAR GOR |
| Credential | NP |
| Practice Address |
1900 Woodland Dr Coos Bay OR 97420-2099 |
| Mailing Address |
705 Edwards Ave Coos Bay OR 97420-3408 |
| Practice Telephone | 5412675151 |
| Mailing Telephone | 5414041414 |
| Enumeration Date | 2019-12-03 |
| Last Update Date | 2019-12-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
201909528NP-PP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1900 WOODLAND DR |
| City | COOS BAY |
| State | OR |
| Zip Code | 97420-2099 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174517528 | Mary Irene Hernandez | Physical Therapist | 1900 Woodland Dr, Coos Bay, OR 97420 | 2005-08-31 |
| 1477189009 | Sandy Lynn Teeter | Nurse Practitioner | 1900 Woodland Dr, Coos Bay, OR 97420-2099 | 2020-03-16 |
| 1568014942 | Nikkona Henderson | Nurse Practitioner | 1900 Woodland Dr, Coos Bay, OR 97420-2045 | 2019-07-15 |
| 1861050189 | James Murray | Dermatology | 1900 Woodland Dr, Coos Bay, OR 97420-2099 | 2019-06-01 |
| 1346803640 | Sophia Elizabeth Massey | Nurse Practitioner | 1900 Woodland Dr, Coos Bay, OR 97420-2099 | 2019-04-22 |
| 1750857090 | Alaina Therese Hendrix | Nurse Practitioner | 1900 Woodland Dr, Coos Bay, OR 97420-2099 | 2018-10-14 |
| 1801382155 | Yulia Viktorovna Whidden | Nurse Practitioner | 1900 Woodland Dr, Coos Bay, OR 97420-2099 | 2018-07-10 |
| 1124525043 | Samantha Decker | Dermatology | 1900 Woodland Dr, Coos Bay, OR 97420-2099 | 2018-04-07 |
| 1043712383 | Gregory Sopka | Physician Assistant | 1900 Woodland Dr, Coos Bay, OR 97420-2045 | 2018-03-02 |
| 1477052470 | Magdalene Clare Shaughnessy | Physician Assistant | 1900 Woodland Dr, Coos Bay, OR 97420-2045 | 2018-02-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346880606 | Danielle Goette | Massage Therapist | 320 Central Ave Suite 226, Coos Bay, OR 97420 | 2020-01-14 |
| 1730643735 | Nicole Hand-therapeutic Massage | Massage Therapist | 3229 Broadway Avenue, Suite D, Coos Bay, OR 97420 | 2019-01-24 |
| 1528531100 | A Better Reality | Clinic/Center | 2690 N. 17th Sstreet, Coos Bay, OR 97420 | 2019-01-07 |
| 1396216883 | Elizabeth Rose Stephens | Health Educator | 97381 Newport Lane, Coos Bay, OR 97420 | 2018-12-10 |
| 1093263386 | Megan Smith | Physician Assistant | 375 Park Ave Ste 5, Coos Bay, OR 97420 | 2016-09-14 |
| 1285091884 | Richard T Rigney | Counselor | 62754 Karl Road, Coos Bay, OR 97420 | 2016-01-27 |
| 1821493032 | James Thomas Agee | Pharmacist | 2051 Newmark Avenue, Walmart Pharmacy 1880, Coos Bay, OR 97420 | 2014-10-30 |
| 1346663895 | Steven D. Richardson D.m.d. L.l.c | Dentist | 1835 Ocean Blvd Se, Coos Bay, OR 97420 | 2014-02-03 |
| 1144669243 | Michael Jason Cole | Pharmacist | 1020 South First Ave, Coos Bay, OR 97420 | 2013-06-21 |
| 1639518053 | Jonathan Thomas Small | Physical Therapist | 2645 North 17th St, Coos Bay, OR 97420 | 2013-06-19 |
| Find all providers in zip 97420 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568096188 | Heath Gerig | Nurse Practitioner | 1750 Thompson Rd, Coos Bay, OR 97420-2100 | 2020-02-24 |
| 1568014942 | Nikkona Henderson | Nurse Practitioner | 1900 Woodland Dr, Coos Bay, OR 97420-2045 | 2019-07-15 |
| 1407362197 | Jesse Allen Dorfmeister | Nurse Practitioner | 1900 Woodland Dr, Coos Bay, OR 97420-2045 | 2017-12-18 |
| 1154877025 | Patrick Timothy Bringardner | Nurse Practitioner | 1900 Woodland Dr, Coos Bay, OR 97420-2045 | 2016-08-30 |
| 1366825341 | Pei J Purdom | Nurse Practitioner | 1900 Woodland Dr, Coos Bay, OR 97420-2099 | 2015-07-08 |
| 1720483266 | Jason Hayes | Nurse Practitioner | 1750 Thompson Rd, Coos Bay, OR 97420-2100 | 2014-10-27 |
| 1699191510 | Saralyn Veech | Nurse Practitioner | 1775 Thompson Rd, Coos Bay, OR 97420-2125 | 2014-03-17 |
| 1134561814 | Denise J Gontiz | Nurse Practitioner | 1900 Woodland Dr, Coos Bay, OR 97420-2099 | 2013-07-23 |
| 1164860383 | Carrie Ann Kralicek | Nurse Practitioner | 153 N Broadway, Coos Bay, OR 97420-1633 | 2013-06-10 |
| 1942543749 | Jodi Deann Strand | Nurse Practitioner | 1775 Thompson Rd, Coos Bay, OR 97420-2198 | 2013-03-29 |
| Find all providers in COOS BAY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.