NPIMap

Organization Active NPI

Cofas Inc

  • Internal Medicine Physician
  • Klamath Falls, OR
National Provider Identifier
1033179684
Registry record updated May 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD25846 Issued in OR
Legal business name
COFAS INC
Practice address
2218 Shallock Ave
Klamath Falls, OR 97601-4290
Phone
(541) 882-3818
Fax
(541) 882-9800
NPI assigned
Mar 27, 2006
Last updated
May 16, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2019

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

Authorized official

Name
Charles Keith Cofas, MDNPI 1053371666
Title
Owner/MD
Phone
(541) 882-3818

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD11585 OR
Internal Medicine Physician 207R00000X MD25846 OR Primary
Physician Assistant 363A00000X PA01446 OR

Addresses

Primary practice location

2218 Shallock Ave
Klamath Falls, OR 97601-4290

Mailing address

2218 Shallock Ave
Klamath Falls, OR 97601-4290
Phone (541) 882-3818

Other identifiers 2

IdentifierTypeStateIssuer
027754MedicaidOR
DE8224OtherORRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060410000032 OR Part B Supplier - Clinic/Group Practice 1456360114 Receives reassigned benefits from 7 practitioners
Practice locations: Klamath Falls, OR

National Provider Directory

National Provider Directory

Locations

2640 Biehn St
Ste 4
Klamath Falls, OR 97601
Phone (541) 882-3818

2682 Campus Dr
Klamath Falls, OR 97601
Phone (832) 725-5995

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25961/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557964800000",
    "number": "1033179684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2218 SHALLOCK AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976014290",
            "telephone_number": "541-882-3818",
            "fax_number": "541-882-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2218 SHALLOCK AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976014290",
            "telephone_number": "541-882-3818",
            "fax_number": "541-882-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COFAS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-27",
        "last_updated": "2019-05-16",
        "status": "A",
        "authorized_official_last_name": "COFAS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "OWNER/MD",
        "authorized_official_telephone_number": "541-882-3818",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD11585",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD25846",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA01446",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "027754",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DE8224",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Klamath Falls, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.