DR. KELLY ANN GOLDBERG (NPI# 1336428606) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336428606 |
| Entity Type | Individual |
| Full Name | DR. KELLY ANN GOLDBERG |
| Credential | D.C. |
| Practice Address |
3201 Se J St Bentonville AR 72712 |
| Mailing Address |
3102 Se J St Bentonville AR 72712-3796 |
| Practice Telephone | 4792733150 |
| Mailing Telephone | 4792733150 |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2013-07-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | 6294 | GA | Chiropractic Providers |
| Y | 111N00000X | Chiropractor | 15727 | AR | Chiropractic Providers |
| Street Address |
3201 SE J ST |
| City | BENTONVILLE |
| State | AR |
| Zip Code | 72712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427662345 | Bentonville Ambulatory Surgery Center, LLC | Pain Medicine | 2902 We Mid-cities Dr, Bentonville, AR 72712 | 2020-09-08 |
| 1942837059 | Amy Crumpton | Counselor | 3504 Se Riveria Road, Bentonville, AR 72712 | 2020-03-26 |
| 1295361509 | Unbridled Holdings LLC | Physical Therapy Assistant | 9900 Price Coffee Rd, Bentonville, AR 72712 | 2020-03-18 |
| 1649803552 | Hanna Kathryn Baxendale | Pediatrics | 2900 Medical Pkwy, Ste #370, Bentonville, AR 72712 | 2020-02-19 |
| 1740746635 | Meredith C Hodges | Counselor | 2508 Se 2oth St, Bentonville, AR 72712 | 2019-02-15 |
| 1609352566 | Tripharma Inc | Pharmacy | 3500 Sw Regional Airport Blvd Ste 2, Bentonville, AR 72712 | 2018-07-13 |
| 1811406747 | Upspring Therapy, LLC | Counselor | 2106 Sw Walton Blvd, Suite B, Bentonville, AR 72712 | 2017-09-22 |
| 1023536836 | Charlotte Yuvonne Hoyle | Case Manager/Care Coordinator | 2005 S.e Walton Blvd., Bentonville, AR 72712 | 2017-08-31 |
| 1508399502 | Rosanna Nicole Rephan | Nurse Practitioner | 3101 14th St, Mercy Convenient Care, Bentonville, AR 72712 | 2017-04-06 |
| 1417305517 | Charlotte Lennette Stephenson | Behavioral Analyst | 2005 S.e. Walton Blvd., Bentonville, AR 72712 | 2016-05-31 |
| Find all providers in zip 72712 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306302393 | Mitchell Chiropractic Pllc | Chiropractor | 201b Ne 3rd St, Bentonville, AR 72712-5308 | 2019-02-14 |
| 1700350378 | Anthony Orlando Le | Chiropractor | 1706 Se Walton Blvd Ste 6, Bentonville, AR 72712-3201 | 2019-01-17 |
| 1922580901 | Deep Roots Health Center Inc | Chiropractor | 103 Sw Winsted Ln Ste 25, Bentonville, AR 72713-6203 | 2018-09-05 |
| 1356834998 | Ashley Monet Mcelroy | Chiropractor | 2303 Sw Primrose Ave, Bentonville, AR 72713 | 2018-06-08 |
| 1700330750 | Christopher Taylor Elder | Chiropractor | 1803 Sw Regional Airport Blvd Ste 9, Bentonville, AR 72712-8792 | 2016-08-08 |
| 1760837652 | Arbor Vitae Chiropractic Inc | Chiropractor | 1401 S Walton Blvd Ste 25, Bentonville, AR 72712-6139 | 2016-04-28 |
| 1902296361 | Andrew Badell | Chiropractor | 3103 N Walton Blvd Ste B, Bentonville, AR 72712-3944 | 2015-01-23 |
| 1326476888 | Justin Beagley | Chiropractor | 302 Sw 6th St Ste 12, Bentonville, AR 72712-5771 | 2013-10-21 |
| 1346686391 | Better Body Solutions Pllc | Chiropractor | 902b S Walton Blvd, Suite 18, Bentonville, AR 72712-6237 | 2013-05-17 |
| 1710293618 | Harvey James Roeder IIi | Chiropractor | 1401 Se Walton Blvd, 113, Bentonville, AR 72712-3759 | 2010-08-30 |
| Find all providers in BENTONVILLE | ||||
| City | BENTONVILLE |
| Zip Code | 72712 |
Please comment or provide details below to improve the information on DR. KELLY ANN GOLDBERG.
| 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.