Individual provider Active NPI

Kathie J Lang, M.D.

  • Family Medicine Physician
  • Klamath Falls, OR
National Provider Identifier
1285682070
Registry record updated Oct 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD22164 Issued in OR
Practice address
3737 Shasta Way Ste a
Klamath Falls, OR 97603-4982
Phone
(541) 883-2337
Fax
(541) 883-2504
NPI assigned
May 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD22164 OR Primary

Addresses

Primary practice location

3737 Shasta Way Ste a
Klamath Falls, OR 97603-4982

Mailing address

3737 Shasta Way Ste a
Klamath Falls, OR 97603-4982
Phone (541) 883-2337

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040430000271 OR Practitioner - Family Practice 0840287744 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Icco, LLC CurrentSince Mar 10, 2020 Accepting new patients
Advanced Aesthetics and Wellness CurrentSince Sep 9, 2023 Accepting new patients
Icco LLC CurrentSince Mar 10, 2020 Accepting new patients
Icco, LLC Current Accepting new patients
Central Oregon Dermatology, PC Past Accepting new patients

Locations

598 E 13th Ave
Eugene, OR 97401
Phone (541) 636-3473

3150 S 6th St
Klamath Falls, OR 97603
Phone (541) 273-5433

3737 Shasta Way
Ste A
Klamath Falls, OR 97603
Phone (541) 883-2337

Interoperability endpoints

  • Direct secure messaging: advancedaesthetics.kathielang@155325.advancedmd-direct.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/BIAFAA

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288051200000",
    "number": "1285682070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 SHASTA WAY STE A",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976034982",
            "telephone_number": "541-883-2337",
            "fax_number": "541-883-2504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 SHASTA WAY STE A",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976034982",
            "telephone_number": "541-883-2337",
            "fax_number": "541-883-2504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANG",
        "first_name": "KATHIE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2010-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD22164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Klamath Falls, OR

Sources for this page

Verify at the official NPI Registry.