Evening Medical Clinic

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

EVENING MEDICAL CLINIC

Practice address

1252 Bennett Ave
Suite B
Burley, ID 83318

Phone

(208) 878-3486

Fax

(208) 878-2005

NPI assigned

Jun 1, 2007

Last updated

Jul 16, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael P Klett, DONPI 1821106899

Title

Owner

Phone

(208) 878-5255

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Michael P Klett, D.O.

  • Family Medicine Physician
  • Burley, ID
  • NPI 1821106899
  Authorized official Same address or phone

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279238400000",
    "number": "1043412133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1252 BENNETT AVE",
            "address_2": "SUITE B",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "83318",
            "telephone_number": "208-878-3486",
            "fax_number": "208-878-2005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1252 BENNETT AVE",
            "address_2": "SUITE B",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "83318",
            "telephone_number": "208-878-3486",
            "fax_number": "208-878-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVENING MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-01",
        "last_updated": "2010-07-16",
        "status": "A",
        "authorized_official_last_name": "KLETT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-878-5255",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Service Clinic/Center in Burley, ID
• Providers in Burley, ID by specialty
• Health Service Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2010; 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.