John C Klinkenborg, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5316A Issued in WY

Practice address

634 S 3Rd St
Lander, WY 82520-3708

Phone

(307) 349-3149

Fax

(307) 332-7300

NPI assigned

Dec 19, 2006

Reactivated

Feb 22, 2008

Last updated

Feb 20, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• US Health Dept of Health & Human Services

  • Federal Public Health Clinic/Center
  • Arapahoe, WY
  • NPI 1104976372
  NPD (past)

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487548800000",
    "number": "1083777080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "634 S 3RD ST",
            "city": "LANDER",
            "state": "WY",
            "postal_code": "825203708",
            "telephone_number": "307-349-3149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "634 S 3RD ST",
            "city": "LANDER",
            "state": "WY",
            "postal_code": "825203708",
            "telephone_number": "307-349-3149",
            "fax_number": "307-332-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINKENBORG",
        "first_name": "JOHN",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2017-02-20",
        "deactivation_date": "2007-07-17",
        "reactivation_date": "2008-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WY",
            "license": "5316A",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G58074",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lorin Brent Kaufman, MPT
• Kid's Case Management
• Maria C Kidner, DNP, FNP-BC, FAANP
• Kyle Kienlen-Trujillo, M.S., CCC-SLP
• John Kindle, DPT
• Knell Access Management
• Knell Access Management
• Tanya L Knell, MSED
• Nicholas N Koch, DPT
• David A Krise, DDS

• Family Medicine Physician in Lander, WY
• Providers in Lander, WY by specialty
• Family Medicine Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; 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.