Klamath Surgical Associates PC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD11222 Issued in OR

Legal business name

KLAMATH SURGICAL ASSOCIATES PC

Practice address

2200 Bryant Williams Dr
Klamath Falls, OR 97601-1120

Phone

(541) 883-3391

Fax

(541) 883-2250

NPI assigned

Jan 16, 2007

Last updated

Nov 2, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Edward Thomas McClure, M.D.NPI 1013004548

Title

Owner

Phone

(541) 883-3391

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 3

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.

• Edward Thomas McClure, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Klamath Falls, OR
  • NPI 1013004548
  NPD (past) Authorized official
• Mark F Bradbury, M.D.

  • Surgery Physician
  • Klamath Falls, OR
  • NPI 1053351221
  NPD (past)
• Jason Kent Winebarger, PA-C

  • Surgical Physician Assistant
  • Bend, OR
  • NPI 1376660597
  NPD (past)

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193961600000",
    "number": "1861543720",
    "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": "2200 BRYANT WILLIAMS DR",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011120",
            "telephone_number": "541-883-3391",
            "fax_number": "541-883-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KLAMATH SURGICAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-11-02",
        "status": "A",
        "authorized_official_last_name": "MCCLURE",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-883-3391",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "OR",
            "license": "MD11222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CN5695",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006213",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Klamath Physician Assistants LLC
• Klamath Psychological Assessment Services, Inc.
• Klamath Radiology Associates PC
• Klamath Smiles, LLC
• Klamath Surgery Center LLC (Klamath Surgery Center)
• Klamath Surgical Specialists. PC
• Klamath Tribal Health & Family Services (Klamath Youth Regional Treatment Center)
• Klamath Tribal Health & Family Services (Klamath Tribal Pharmacy - Klamath Falls)
• Klamath Tribal Health and Family Services
• Klamath Walk in Care Center Inc.

• Surgery Physician in Klamath Falls, OR
• Providers in Klamath Falls, OR by specialty
• Surgery Physician in Oregon

• 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.

Verify at the official NPI Registry.