Active NPI
Stefan Jodko, M.D.
- Anesthesiology Physician
- Klamath Falls, OR
National Provider Identifier
1740238377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- MD18158
- Practice address
- 2865 Daggett Ave
Klamath Falls, OR 97601-1106 - Phone
- (541) 882-6311
- NPI assigned
- May 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | MD18158 | OR | Primary |
Addresses
Primary practice location
2865 Daggett Ave
Klamath Falls, OR 97601-1106
Mailing address
PO Box 1359
Klamath Falls, OR 97601-0075
Phone (541) 882-1540
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 056130 | Medicaid | OR |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD18158 | OR | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193961600000",
"number": "1740238377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1359",
"city": "KLAMATH FALLS",
"state": "OR",
"postal_code": "976010075",
"telephone_number": "541-882-1540",
"fax_number": "541-882-2583"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2865 DAGGETT AVE",
"city": "KLAMATH FALLS",
"state": "OR",
"postal_code": "976011106",
"telephone_number": "541-882-6311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JODKO",
"first_name": "STEFAN",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-05",
"last_updated": "2007-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "OR",
"license": "MD18158",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "056130",
"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 Nov 2, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.