Individual provider Active NPI

Lyle Stephen Shrifter, MSW.

  • Clinical Social Worker
  • Klamath Falls, OR
National Provider Identifier
1124174412
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
284 Issued in OR
Practice address
410 N 9TH St
Klamath Falls, OR 97601-2805
Phone
(541) 884-2357
Fax
(541) 882-6406
NPI assigned
Jan 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 284 OR Primary

Addresses

Primary practice location

410 N 9TH St
Klamath Falls, OR 97601-2805

Mailing address

7630 Cannon Ave
Klamath Falls, OR 97603-9498
Phone (541) 884-2357

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060316000513 OR Practitioner - Clinical Social Worker 5799792628 Practice locations: Sherwood, OR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

23374 SW Old Hwy 99W
Sherwood, OR 97140-8640
Phone (541) 602-8297

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
284ORMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1169856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124174412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7630 CANNON AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976039498",
            "telephone_number": "541-884-2357",
            "fax_number": "541-882-6406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N 9TH ST",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976012805",
            "telephone_number": "541-884-2357",
            "fax_number": "541-882-6406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHRIFTER",
        "first_name": "LYLE",
        "middle_name": "STEPHEN",
        "name_prefix": "Mr.",
        "credential": "MSW.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Klamath Falls, OR

Sources for this page

Verify at the official NPI Registry.