Gregory H Wlodarski, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

95-01458 Issued in NC

Practice address

2821 Daggett Ave Ste 200
Klamath Falls, OR 97601-1106

Phone

(541) 274-8400

Fax

(541) 274-8405

NPI assigned

Jul 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pinetree Clinic, PLLC

  • Family Medicine Physician
  • Pinehurst, NC
  • NPI 1598896805
  NPD (past) Authorized official

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1891712592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "289 OLMSTED BLVD STE 7",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283749023",
            "telephone_number": "910-295-2900",
            "fax_number": "910-295-2935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 DAGGETT AVE STE 200",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011106",
            "telephone_number": "541-274-8400",
            "fax_number": "541-274-8405"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "289 Olmsted Blvd Ste 7",
            "address_purpose": "LOCATION",
            "city": "Pinehurst",
            "state": "NC",
            "postal_code": "283749023",
            "country_code": "US",
            "telephone_number": "910-295-2900",
            "fax_number": "910-295-2935",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "250 Fort St",
            "address_purpose": "LOCATION",
            "city": "Neah Bay",
            "state": "WA",
            "postal_code": "983574003",
            "country_code": "US",
            "telephone_number": "360-645-2233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WLODARSKI",
        "first_name": "GREGORY",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD192071",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "95-01458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500762160",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "88721",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8988721",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul A Winkler II, PA-C
• Nellie May Wirsing, MD
• Jennifer Renee Wise, MD
• Julie Wisecup
• Leeandria N. Witcraft, LCSW
• Laurel Wolf, P.T.
• Joanna Wolverton, RD, CDCES
• Womencare Health Center LLC
• Sarah Michelle Wonn, M.D.
• Jaccob Joseph Wonser

• Family Medicine Physician in Klamath Falls, OR
• Providers in Klamath Falls, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; 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.