Individual provider Active NPI

Bobijo Staffler, FNP

  • Nurse Practitioner
  • Klamath Falls, OR
National Provider Identifier
1962001586
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
202008469NP-PP Issued in OR
Practice address
2850 Daggett Ave
Klamath Falls, OR 97601-1107
Phone
(541) 274-8610
NPI assigned
Oct 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 202008469NP-PP OR Primary

Addresses

Primary practice location

2850 Daggett Ave
Klamath Falls, OR 97601-1107

Mailing address

2850 Daggett Ave
Klamath Falls, OR 97601-1107
Phone (541) 274-8610

Other names 1

  • Bobijo Wheelock Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bobi.wheelock@skylakes.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210218000467 OR Practitioner - Nurse Practitioner 5193130433 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sky Lakes Medical Center IncGroup PAC ID 1052204096, 196 clinicians

Practice addresses (Care Compare)

2850 Daggett Ave
Klamath Falls, OR 97601-1107
Phone (541) 274-8610

Hospital & facility affiliations

  • Sky Lakes Medical Center Hospital, Klamath Falls, OR, CCN 380050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
202008469NP-PPORMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sky Lakes Medical Center Inc CurrentSince Dec 14, 2020 Accepting new patients
Sky Lakes Medical Center Inc CurrentSince Dec 14, 2020 Accepting new patients

Locations

2865 Daggett Ave
Klamath Falls, OR 97601
Phone (541) 833-6221

2850 Daggett Ave
Klamath Falls, OR 97601
Phone (541) 274-8610

2801 Daggett Ave
Klamath Falls, OR 97601
Phone (541) 274-4510

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1603411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1962001586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 DAGGETT AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011107",
            "telephone_number": "541-274-8610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 DAGGETT AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011107",
            "telephone_number": "541-274-8610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAFFLER",
        "first_name": "BOBIJO",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-23",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "202008469NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bobi.wheelock@skylakes.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2850 Daggett Ave",
            "city": "Klamath Falls",
            "state": "OR",
            "country_code": "US",
            "postal_code": "976011107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BOBIJO",
            "last_name": "WHEELOCK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Klamath Falls, OR

Sources for this page

Verify at the official NPI Registry.