Traci Nichole Gansberg, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

201605976NP-PP Issued in OR

Practice address

2821 Daggett Ave Ste 200
Klamath Falls, OR 97601-1106

Phone

(541) 274-8400

Fax

(541) 274-8405

NPI assigned

Aug 1, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Icco LLCGroup PAC ID 1355406729, 133 clinicians

Sky Lakes Medical Center IncGroup PAC ID 1052204096, 196 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Icco, LLC

  • Urgent Care Clinic/Center
  • Eugene, OR
  • NPI 1407004757
  Medicare reassignment Care Compare group NPD
• Sky Lakes Medical Center Inc

  • General Acute Care Hospital
  • Klamath Falls, OR
  • NPI 1659340370
  Medicare reassignment Care Compare group NPD
• Klamath Orthopedic Clinic PC

  • Specialist
  • Klamath Falls, OR
  • NPI 1811919913
  Medicare reassignment NPD
• Icco LLC

  • Rural Health Clinic/Center
  • Florence, OR
  • NPI 1740896547
  NPD
• Icco, LLC

  • Urgent Care Clinic/Center
  • Eugene, OR
  • NPI 1902131022
  NPD
• Sky Lakes Medical Center Inc

  • Community/Retail Pharmacy
  • Klamath Falls, OR
  • NPI 1003654625
  NPD

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

• Sky Lakes Medical Center Inc

  • Occupational Therapist
  • Klamath Falls, OR
  • NPI 1134270911

  Hospital

  Care Compare affiliation
• Sky Lakes Medical Center Inc

  • General Acute Care Hospital
  • Klamath Falls, OR
  • NPI 1659340370
  Care Compare affiliation

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

{
    "created_epoch": "1470009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1336692813",
    "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": "541-274-8400",
            "fax_number": "541-274-8405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 DAGGETT AVE STE 200",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011106",
            "telephone_number": "541-274-8400",
            "fax_number": "541-274-8405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANSBERG",
        "first_name": "TRACI",
        "middle_name": "NICHOLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-01",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201605976NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacklyn Gallimore
• Brittany Galloway, PHARMD
• Shannon Lee Galpin, FNP
• Anne Ganong-Taylor
• Carrie Atwell Ganong, M.D.
• Alvaro Eduardo Garay
• Brandy Garcia
• Dennis Garcia
• Rachel Camille Garcia
• Sabrina Flint Garcia

• Family Nurse Practitioner in Klamath Falls, OR
• Providers in Klamath Falls, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.