Organization Active NPI

Wholesome Family Medicine

  • Naturopath
  • Klamath Falls, OR
National Provider Identifier
1700393576
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
3053 Issued in OR
Legal business name
WHOLESOME FAMILY MEDICINE
Practice address
4036 S 6TH St Ste 2
Klamath Falls, OR 97603
Phone
(541) 851-9320
Fax
(541) 851-9322
NPI assigned
Jan 3, 2018
Last updated
Apr 6, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Authorized official

Name
Laura Blevins, NDNPI 1043680796
Title
Owner
Phone
(541) 851-9320

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Naturopath 175F00000X 3053 OR Primary

Addresses

Primary practice location

4036 S 6TH St Ste 2
Klamath Falls, OR 97603

Mailing address

4036 S 6TH St Ste 2
Klamath Falls, OR 97603-4750
Phone (541) 851-9320

Other identifiers 1

IdentifierTypeStateIssuer
500694147MedicaidOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210406001604 OR Part B Supplier - Clinic/Group Practice 2466869649 Receives reassigned benefits from 2 practitioners
Practice locations: Klamath Falls, OR

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
38D2136209Wholesome Family Medicine, LLC4036 S 6TH Street Suite 2, Klamath Falls, OR 97603Certificate of waiverSep 4, 2027

National Provider Directory

National Provider Directory

Locations

4036 S 6th St
Ste 2
Klamath Falls, OR 97603
Phone (541) 851-9320

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16628/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1514937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617667200000",
    "number": "1700393576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4036 S 6TH ST STE 2",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976034750",
            "telephone_number": "541-851-9320",
            "fax_number": "541-851-9322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4036 S 6TH ST STE 2",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "97603",
            "telephone_number": "541-851-9320",
            "fax_number": "541-851-9322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHOLESOME FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-03",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A",
        "authorized_official_last_name": "BLEVINS",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-851-9320",
        "authorized_official_credential": "ND"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "OR",
            "license": "3053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500694147",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Apr 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.