NPIMap

Organization Active NPI

Klamath Hospice, Inc.

  • Community Based Hospice Care Agency
  • Klamath Falls, OR
National Provider Identifier
1407967557
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
KLAMATH HOSPICE, INC.
Practice address
2751 Washburn Way
Klamath Falls, OR 97603-4958
Phone
(541) 882-2902
Fax
(541) 883-1992
NPI assigned
Aug 31, 2006
Last updated
Jun 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

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

Authorized official

Name
Mrs. Rachel Throne
Title
Executive Director
Phone
(541) 882-2902

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X NU Primary

Addresses

Primary practice location

2751 Washburn Way
Klamath Falls, OR 97603-4958

Mailing address

2751 Washburn Way
Klamath Falls, OR 97603-4958
Phone (541) 882-2902

Other identifiers 2

IdentifierTypeStateIssuer
132634MedicaidOR
HPC00006FOtherCAMEDICAL ID NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050201000720 OR Part A Provider - Hospice 2668423203 Practice locations: Klamath Falls, OR
O20240430002009 OR Part B Supplier - Clinic/Group Practice 2668423203 Receives reassigned benefits from 2 practitioners
Practice locations: Klamath Falls, OR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407967557. Details of each certification follow.

Hospice certification: CCN 381533

Legal name
KLAMATH HOSPICE, INC.
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jul 6, 1995
Last certification
May 25, 2022
Ownership / control type
Non-Profit - Other
Organization structure
CorporationNon-profit
Incorporated
May 22, 1980 in OR
Enrollment address
2751 Washburn Way
Klamath Falls, OR 97603-4517

Care Compare: Hospice

Medicare Care Compare
Listed as
Klamath Hospice, Inc.CCN 381533 · All quality measures
Ownership
Non-Profit
Certified
Jul 6, 1995
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D1104172Klamath Hospice Inc2751 Washburn Way, Klamath Falls, OR 97603Certificate of waiverAug 25, 2027

National Provider Directory

National Provider Directory

Locations

2751 Washburn Way
Klamath Falls, OR 97603
Phone (541) 882-2902

437 Main St
Klamath Falls, OR 97601
Phone (503) 731-4013

4745 S 6th St
Klamath Falls, OR 97603
Phone (541) 882-2902

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Rhiannon Skye Kerr Individual Corporate DirectorBoard Member May 1, 2022
Thomas Joel Hottman Individual Corporate DirectorBoard Member Oct 1, 2013
Toni Christine McMillan Individual Corporate DirectorBoard Member May 1, 2022
Rachel Renee Misso Individual Corporate DirectorBoard Member Feb 1, 2018
Angie Lynne Lawler Individual Corporate OfficerVice-President Feb 1, 2020
Nancy Leota Baley Individual Corporate DirectorBoard Member Jun 1, 2016
Brannon Lynn Kaefring Individual Corporate OfficerSecretary Oct 1, 2020
Regina Ann Kullrich Individual Corporate OfficerPresident Feb 1, 2017
Rachel Alene Throne Individual Corporate DirectorExecutive Director Jul 20, 2014
W-2 Managing EmployeeChief Financial Officer Sep 5, 2005
Victor Joseph Nork Individual Corporate DirectorBoard Member Sep 30, 2022

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 12

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687132800000",
    "number": "1407967557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2751 WASHBURN WAY",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976034958",
            "telephone_number": "541-882-2902",
            "fax_number": "541-883-1992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2751 WASHBURN WAY",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976034958",
            "telephone_number": "541-882-2902",
            "fax_number": "541-883-1992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KLAMATH HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A",
        "authorized_official_last_name": "THRONE",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "541-882-2902",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132634",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL ID NUMBER",
            "identifier": "HPC00006F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Klamath Falls, OR

Sources for this page

Verify at the official NPI Registry.