Organization Active NPI

Karl C Wenner MD PC

  • Specialist
  • Klamath Falls, OR
National Provider Identifier
1043430747
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD15968 Issued in OR
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

Updated by the provider on Mar 7, 2023

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)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
098830MedicaidOR
XPY1138303OtherCAMEDICAL
055587000OtherORBLUE CROSS
DG2429OtherORRAIL ROAD MEDICARE

National Provider Directory

National Provider Directory

NPI 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.

Verify at the official NPI Registry.