Gail K McClave MD LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

GAIL K MCCLAVE MD LLC

Practice address

475 Elmira Ave SE
Suite 103
Bandon, OR 97411-7405

Phone

(541) 347-2111

Fax

(541) 347-1212

NPI assigned

Nov 2, 2006

Organization subpart

No

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

Authorized official

Name

Gail Koch McClave, MD

Title

Owner

Phone

(541) 347-2111

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• LLC Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mary Nell Anker, N.P.

  • Nurse Practitioner
  • Bandon, OR
  • NPI 1568451383
  NPD (past)

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400198400000",
    "number": "1740368901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 393",
            "city": "BANDON",
            "state": "OR",
            "postal_code": "97411",
            "telephone_number": "541-347-2111",
            "fax_number": "541-347-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 ELMIRA AVE SE",
            "address_2": "SUITE 103",
            "city": "BANDON",
            "state": "OR",
            "postal_code": "974117405",
            "telephone_number": "541-347-2111",
            "fax_number": "541-347-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAIL K MCCLAVE MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2014-05-16",
        "status": "A",
        "authorized_official_last_name": "MCCLAVE",
        "authorized_official_first_name": "GAIL",
        "authorized_official_middle_name": "KOCH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-347-2111",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287386",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Heidi Noel Hanst, MD

• All providers in Bandon, OR
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2014; 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.