KOD @ KBBH – Federally Qualified Health Center (FQHC), NPI 1417411505

KOD @ KBBH is a healthcare provider. based in Klamath falls, Oregon. specializing in Federally Qualified Health Center (FQHC). The NPI Number for KOD @ KBBH is 1417411505

Main info

Organization
Name
KOD @ KBBH
NPI
1417411505
Phone
(541) 880-2011
Address
2074 S 6TH ST
Authorized Official
JEANA MASTERS CPES
Enumeration Date
23 January 2019
Last Update Date
6 August 2020
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience29
Completeness80
Years active:7State licenses:0Digital endpointsUpdated within 12 months

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Provider Addresses for KOD @ KBBH

  • South 6th Street, Klamath Falls, Klamath County, Oregon, 97603, United States

    KLAMATH FALLS, OR 976013372

    Phone: (541) 880-2011

    Type: Mailing

  • North Eldorado Avenue, Pacific Terrace, Klamath Falls, Klamath County, Oregon, 97601, United States

    KLAMATH FALLS, OR 976016418

    Phone: (541) 883-1030

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2023-12-31 (891 days ago).

Enrollment records

1

Earliest due date

2023-12-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20040122000731OClinic/Group PracticeOR2023-12-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97601)

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Reviews

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Frequently asked questions

What is the standard ID for KOD @ KBBH in the U.S.?
In the U.S., KOD @ KBBH is identified by NPI 1417411505.
Is KOD @ KBBH's NPI status active today?
Active status means KOD @ KBBH's NPI record is not deactivated in the public file.
What services align with KOD @ KBBH's listing?
KOD @ KBBH's public classification highlights Federally Qualified Health Center (FQHC). Clinical services aligned with this taxonomy classification.
What city is tied to KOD @ KBBH?
The directory associates KOD @ KBBH with Klamath Falls, Oregon. Check all listed addresses for suites or satellite offices.
Can I export KOD @ KBBH's record?
You can download the official NPPES record; we summarize key fields for readability.

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