Kevin T Heaton DO PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

DO22887 Issued in OR

Legal business name

KEVIN T HEATON DO 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

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

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in OR2 enrollments

Enrollment records 2

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kevin T Heaton, DO

  • Orthopaedic Surgery Physician
  • Klamath Falls, OR
  • NPI 1467474569
  Medicare reassignment
• Miguel A Schmitz, MD

  • Orthopaedic Surgery Physician
  • Spokane Valley, WA
  • NPI 1023031119
  NPD (past)

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": "1073733671",
    "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": "KEVIN T HEATON DO 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": "DO22887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287483",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "XPY195175",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "DG2430",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "4604977397601",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "831170000",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rhoda Louise Keown, RN
• Anna Keppen, LMT
• Dena Lynn Keppen, M.S, P.T.
• Hayley Joyce Kessler, PA-C
• Donna Lynne Kettler, R.PH. , M.S.
• Mahi Mobeen Khan, M.D.
• Karla Kiedrowski, MA QMHP
• Kara Kieffer
• Hans H. Kim, MD
• Miranda Crysta Renee Kimball

• Specialist in Klamath Falls, OR
• Providers in Klamath Falls, OR by specialty
• Specialist in Oregon

• 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.
• 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.