Active NPI
Karl C Wenner MD PC
- Specialist
- Klamath Falls, OR
National Provider Identifier
1043430747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MD15968
- Legal business name
- KARL C WENNER MD PC
- Practice address
- 2200 Bryant Williams Dr
Suite 1
Klamath Falls, OR 97601-1120 - Phone
- (541) 884-7746
- Fax
- (541) 884-0848
- NPI assigned
- Apr 26, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jeannette L Gansberg
- Title
- Executive Director
- Phone
- (541) 274-2902
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MD15968 | OR | Primary |
Addresses
Primary practice location
2200 Bryant Williams Dr
Suite 1
Klamath Falls, OR 97601-1120
Mailing address
2200 Bryant Williams Dr
Suite 1
Klamath Falls, OR 97601-1120
Phone (541) 884-7746
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 098830 | Medicaid | OR | |
| XPY1138303 | Other | CA | MEDICAL |
| 055587000 | Other | OR | BLUE CROSS |
| DG2429 | Other | OR | RAIL ROAD MEDICARE |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177545600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1678147200000",
"number": "1043430747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 BRYANT WILLIAMS DR",
"address_2": "SUITE 1",
"city": "KLAMATH FALLS",
"state": "OR",
"postal_code": "976011120",
"telephone_number": "541-884-7746",
"fax_number": "541-884-0848"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 BRYANT WILLIAMS DR",
"address_2": "SUITE 1",
"city": "KLAMATH FALLS",
"state": "OR",
"postal_code": "976011120",
"telephone_number": "541-884-7746",
"fax_number": "541-884-0848"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KARL C WENNER MD PC",
"organizational_subpart": "NO",
"enumeration_date": "2007-04-26",
"last_updated": "2023-03-07",
"status": "A",
"authorized_official_last_name": "GANSBERG",
"authorized_official_first_name": "JEANNETTE",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "541-274-2902"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": "OR",
"license": "MD15968",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "098830",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL",
"identifier": "XPY1138303",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "055587000",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAIL ROAD MEDICARE",
"identifier": "DG2429",
"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 Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.