Edward L Van Tassel DO PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

DO25890 Issued in OR

Legal business name

EDWARD L VAN TASSEL DO PC

Practice address

2200 Bryant Williams Dr
Ste 1
Klamath Falls, OR 97601-1121

Phone

(541) 884-7746

Fax

(541) 274-5705

NPI assigned

Apr 26, 2007

Organization subpart

No

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

Authorized official

Name

Jeannette L Gansberg

Title

Executive Director

Phone

(541) 274-2902

Specialties & licenses 1

Addresses

Other identifiers 4

Practitioners 2

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

• Karl C Wenner, MD

  • Orthopaedic Surgery Physician
  • Klamath Falls, OR
  • NPI 1659393759
  NPD (past)
• Jason Martin Conaughty, M.D.

  • Orthopaedic Surgery Physician
  • Evansville, IN
  • NPI 1962449389
  NPD (past)

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1578783189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 BRYANT WILLIAMS DR",
            "address_2": "STE 1",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011121",
            "telephone_number": "541-884-7746",
            "fax_number": "541-274-5705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BRYANT WILLIAMS DR",
            "address_2": "STE 1",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011121",
            "telephone_number": "541-884-7746",
            "fax_number": "541-274-5705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD L VAN TASSEL DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "GANSBERG",
        "authorized_official_first_name": "JEANNETTE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "541-274-2902"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OR",
            "license": "DO25890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "820591000",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213618",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "DG1609",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "XPY145960",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah Sue Edde
• Brook Colleen Eddy
• Christine Louise Eddy, LCSW
• Tammi Edge
• Matthew Sean Edmonds, M.D.
• Brandon Lee Edwards, PA-C
• Robert Norfleet Edwards, M.D.
• Tyla Josephine Edwards
• Kandis Ege
• Joann Davidson Eiman, PA

• Specialist in Klamath Falls, OR
• Providers in Klamath Falls, OR by specialty
• Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.