Olive Tree Medical Care, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

OLIVE TREE MEDICAL CARE, LLC

Practice address

1803 Main St # B
Klamath Falls, OR 97601-2636

Phone

(541) 887-2200

Fax

(541) 887-2011

NPI assigned

Feb 22, 2021

Organization subpart

No

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

Authorized official

Name

Sara Jeanne Marchessault, FNPNPI 1376909770

Title

Owner

Phone

(541) 887-2200

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sara Jeanne Marchessault, PA-C, FNP-C

  • Family Nurse Practitioner
  • Klamath Falls, OR
  • NPI 1376909770
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1613952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613952000000",
    "number": "1366036238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803B MAIN ST",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976012636",
            "telephone_number": "541-887-2200",
            "fax_number": "541-887-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1803 MAIN ST # B",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976012636",
            "telephone_number": "541-887-2200",
            "fax_number": "541-887-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVE TREE MEDICAL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-22",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A",
        "authorized_official_last_name": "MARCHESSAULT",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "JEANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-887-2200",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ehr2.charmtracker.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1803B Main St",
            "city": "Klamath Falls",
            "state": "OR",
            "country_code": "US",
            "postal_code": "976012636",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Raven Celeste Ohearn
• Candice Ojeda
• Olaoluwasupo T Ojo
• Cheryl Olguin, L.P.C.
• Suzanne Elizabeth Pence Olin, PHARMD, RPH
• Judith Oyama Olson, FNP
• Sasha Olsson, LCSW
• Liban Omar, CASAC
• Oregon Center for Vaginal Excellence Inc. (Heartfelt Obstetrics & Gynecology)
• Oregon Clinical Laboratory LLC

• Primary Care Clinic/Center in Klamath Falls, OR
• Providers in Klamath Falls, OR by specialty
• Primary Care Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.