NPIMap

Organization Active NPI

University Professional Services

Doing business as Child Development & Rehabilitation Center - Klamath Falls

  • Multi-Specialty Clinic/Center
  • Klamath Falls, OR
National Provider Identifier
1659605707
Registry record updated Sep 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
UNIVERSITY PROFESSIONAL SERVICES
Doing business as
Child Development & Rehabilitation Center - Klamath Falls
Practice address
2858 Eberlein Ave
Klamath Falls, OR 97603-4402
Phone
(503) 494-9000
NPI assigned
Sep 22, 2009
Last updated
Sep 22, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
UNIVERSITY PROFESSIONAL SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 22, 2009

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

Authorized official

Name
Tom Heckler
Title
Associate Dean
Phone
(503) 494-4481

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

2858 Eberlein Ave
Klamath Falls, OR 97603-4402

Mailing address

3181 SW Sam Jackson Park Rd
Mail Code Umg
Portland, OR 97239-3011
Phone (503) 494-8417

Other names 1

  • Child Development & Rehabilitation Center - Klamath Falls Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080910000013 OR Part B Supplier - Clinic/Group Practice 4880760107 Receives reassigned benefits from 2,434 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
University Professional Services

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1253577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253577600000",
    "number": "1659605707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "MAIL CODE UMG",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-8417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2858 EBERLEIN AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976034402",
            "telephone_number": "503-494-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY PROFESSIONAL SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY PROFESSIONAL SERVICES",
        "enumeration_date": "2009-09-22",
        "last_updated": "2009-09-22",
        "status": "A",
        "authorized_official_last_name": "HECKLER",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "ASSOCIATE DEAN",
        "authorized_official_telephone_number": "503-494-4481"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Child Development & Rehabilitation Center - Klamath Falls",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Klamath Falls, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2009; 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.