NPIMap

Organization Active NPI

Kyle R Johnson

  • Community/Behavioral Health Agency
  • Klamath Falls, OR
National Provider Identifier
1922479005
Registry record updated Feb 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
KYLE R JOHNSON
Practice address
2210 N Eldorado Ave
Klamath Falls, OR 97601-6418
Phone
(541) 883-1030
NPI assigned
Oct 14, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2016

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

Authorized official

Name
Mr. Kyle Raymond Johnson, B.S
Title
Treatment Specialist
Phone
(541) 883-1030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

2210 N Eldorado Ave
Klamath Falls, OR 97601-6418

Mailing address

2210 N Eldorado Ave
Klamath Falls, OR 97601-6418
Phone (541) 883-1030

Other names 1

  • Klamath Basin Behavioral Health Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D2093209Klamath Basin Behavioral Health2210 N Eldorado Ave, Klamath Falls, OR 97601Certificate of waiverMar 22, 2027

National Provider Directory

National Provider Directory
Tax ID family
Klamath Child and Family Treatment Center8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1444780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454889600000",
    "number": "1922479005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 N ELDORADO AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976016418",
            "telephone_number": "541-883-1030",
            "fax_number": "541-884-2338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 N ELDORADO AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976016418",
            "telephone_number": "541-883-1030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KYLE R JOHNSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-14",
        "last_updated": "2016-02-08",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "RAYMOND",
        "authorized_official_title_or_position": "TREATMENT SPECIALIST",
        "authorized_official_telephone_number": "541-883-1030",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "B.S"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Klamath Basin Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.