Individual provider Active NPI

Marc Evans Jueco Cas

  • Community Health Worker
  • Klamath Falls, OR
National Provider Identifier
1700640273
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
2074 S 6TH St
Klamath Falls, OR 97601-3372
Phone
(154) 185-1811
NPI assigned
Feb 6, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X Primary

Addresses

Primary practice location

2074 S 6TH St
Klamath Falls, OR 97601-3372

Mailing address

2074 S 6TH St
Klamath Falls, OR 97601-3372
Phone (541) 851-8110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1707177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1700640273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2074 S 6TH ST",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976013372",
            "telephone_number": "541-851-8110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2074 S 6TH ST",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976013372",
            "telephone_number": "154-185-1811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAS",
        "first_name": "MARC EVANS",
        "middle_name": "JUECO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-06",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 6, 2024; 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.