Individual provider Active NPI

David Coker, MSPED, QMHP-C

  • Mental Health Counselor
  • Klamath Falls, OR
National Provider Identifier
1144653973
Registry record updated Sep 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
22-QMHPC-001147 Issued in OR
Practice address
2865 Daggett Ave
Klamath Falls, OR 97601-1106
Phone
(541) 274-6311
NPI assigned
Aug 15, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X 22-QMHPC-001147 OR Primary

Addresses

Primary practice location

2865 Daggett Ave
Klamath Falls, OR 97601-1106

Mailing address

2865 Daggett Ave
Klamath Falls, OR 97601-1106
Phone (541) 274-6311

Other identifiers 1

IdentifierTypeStateIssuer
223354MedicaidOR

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
I20240408001367 OR Practitioner - Mental Health Counselor 3072995349 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sky Lakes Medical Center IncGroup PAC ID 1052204096, 196 clinicians

Practice addresses (Care Compare)

2821 Daggett Ave
Suite 100
Klamath Falls, OR 97601-1106
Phone (541) 274-6733

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

Hospital & facility affiliations

  • Sky Lakes Medical Center Hospital, Klamath Falls, OR, CCN 380050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22-QMHPC-001147ORMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sky Lakes Medical Center Inc CurrentSince Feb 21, 2024 Accepting new patients
Sky Lakes Medical Center Inc CurrentSince Feb 21, 2024 Accepting new patients

Locations

2865 Daggett Ave
Klamath Falls, OR 97601
Phone (541) 833-6221

Organizations & group practices 2

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1376524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1144653973",
    "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": "541-274-6311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2865 DAGGETT AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011106",
            "telephone_number": "541-274-6311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COKER",
        "first_name": "DAVID",
        "credential": "MSPED, QMHP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-15",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "22-QMHPC-001147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "223354",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Klamath Falls, OR

Sources for this page

Verify at the official NPI Registry.