Active NPI
Derrick Kleiner, CPO
- Prosthetist
- Grants Pass, OR
National Provider Identifier
1730948589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetist
- Practice address
- 300 Union Ave Ste C
Grants Pass, OR 97527-5861 - Phone
- (541) 955-9678
- Fax
- (541) 471-4909
- NPI assigned
- Mar 14, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotist | 222Z00000X | |||
| Prosthetist | 224P00000X | Primary |
Addresses
Primary practice location
300 Union Ave Ste C
Grants Pass, OR 97527-5861
Mailing address
300 Union Ave Ste C
Grants Pass, OR 97527-5861
Phone (541) 955-9678
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": "1710374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710374400000",
"number": "1730948589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 UNION AVE STE C",
"city": "GRANTS PASS",
"state": "OR",
"postal_code": "975275861",
"telephone_number": "541-955-9678",
"fax_number": "541-471-4909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 UNION AVE STE C",
"city": "GRANTS PASS",
"state": "OR",
"postal_code": "975275861",
"telephone_number": "541-955-9678",
"fax_number": "541-471-4909"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLEINER",
"first_name": "DERRICK",
"credential": "CPO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-03-14",
"last_updated": "2024-03-14",
"certification_date": "2024-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "222Z00000X",
"taxonomy_group": "",
"desc": "Orthotist",
"state": null,
"license": null,
"primary": false
},
{
"code": "224P00000X",
"taxonomy_group": "",
"desc": "Prosthetist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grants Pass, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.