NPIMap

Organization Active NPI

Sky Lakes Medical Center, Inc.

  • Family Medicine Physician
  • Klamath Falls, OR
National Provider Identifier
1124437348
Registry record updated Aug 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SKY LAKES MEDICAL CENTER, INC.
Practice address
2617 Almond St
Klamath Falls, OR 97601-1116
Phone
(541) 274-6221
NPI assigned
Aug 13, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2014

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

Authorized official

Name
Mr. Richard E Rico
Title
VP/Cfo
Phone
(541) 274-6150

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2617 Almond St
Klamath Falls, OR 97601-1116

Mailing address

2865 Daggett Ave
Klamath Falls, OR 97601-1106
Phone (541) 274-6221

National Provider Directory

National Provider Directory
Tax ID family
West Bahavioral Service23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1407888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407888000000",
    "number": "1124437348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2865 DAGGETT AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011106",
            "telephone_number": "541-274-6221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2617 ALMOND ST",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011116",
            "telephone_number": "541-274-6221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKY LAKES MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-13",
        "last_updated": "2014-08-13",
        "status": "A",
        "authorized_official_last_name": "RICO",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "VP/CFO",
        "authorized_official_telephone_number": "541-274-6150",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 13, 2014; 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.