Individual provider Active NPI

Kirsten Balin

  • Family Nurse Practitioner
  • Klamath Falls, OR
National Provider Identifier
1538812979
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
202114190 Issued in OR
Practice address
2821 Daggett Ave
Klamath Falls, OR 97601-1129
Phone
(541) 274-8400
NPI assigned
Jan 26, 2022
Last updated
Aug 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 202114190 OR Primary

Addresses

Primary practice location

2821 Daggett Ave
Klamath Falls, OR 97601-1129

Mailing address

6062 Oconner Rd
Klamath Falls, OR 97603-9722
Phone (541) 892-4012

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220617002610 OR Practitioner - Nurse Practitioner 6204215429 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sky Lakes Medical Center IncGroup PAC ID 1052204096, 196 clinicians
Advanced Aesthetics and WellnessGroup PAC ID 3870949217, 2 clinicians

Practice addresses (Care Compare)

2821 Daggett Ave
Suite 200
Klamath Falls, OR 97601-1130
Phone (541) 274-8400

3150 S 6TH St
Klamath Falls, OR 97603-4612
Phone (541) 851-9008

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
202114190ORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sky Lakes Medical Center Inc CurrentSince May 10, 2022 Accepting new patients
Sky Lakes Medical Center Inc CurrentSince May 10, 2022 Accepting new patients
Advanced Aesthetics and Wellness CurrentSince Sep 9, 2023 Accepting new patients

Locations

2821 Daggett Ave
Ste 200
Klamath Falls, OR 97601
Phone (541) 274-8400

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

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

Interoperability endpoints

  • Direct secure messaging: advancedaestheticsandwellness.kristinbalin@155325.advancedmd-direct.com

Organizations & group practices 3

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.

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": "1643155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1538812979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6062 OCONNER RD",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976039722",
            "telephone_number": "541-892-4012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 DAGGETT AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011129",
            "telephone_number": "541-274-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALIN",
        "first_name": "KIRSTEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-26",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "202114190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Klamath Falls, OR

Sources for this page

Verify at the official NPI Registry.