KETCHIKAN INDIAN CORPORATION (NPI# 1205159571) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205159571 |
| Entity Type | Organization |
| Organization Name | KETCHIKAN INDIAN CORPORATION |
| Other Organization Name | KETCHIKAN INDIAN COMMUNITY |
| Practice Address |
2960 Tongass Ave Ketchikan AK 99901-5742 |
| Practice Telephone | 9072284941 |
| Practice Fax Number | 9072284920 |
| Mailing Telephone | 9072284941 |
| Mailing Fax Number | 9072284920 |
| Enumeration Date | 2010-03-01 |
| Last Update Date | 2010-11-24 |
| Authorized Official Name | DEBBIE PATTON (GENERAL MANAGER) |
| Authorized Official Telephone | 9072284926 |
| Authorized Official Credential | MBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Ketchikan Indian Community | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396153649 | Ketchikan Indian Corporation | Clinic/Center | 2960 Tongass Ave, Ketchikan, AK 99901-5742 | 2014-07-31 |
| 1821120486 | Ketchikan Indian Corporation | Clinic/Center | 2960 Tongass Ave, Business Office, Ketchikan, AK 99901-5742 | 2007-03-09 |
| Street Address |
2960 TONGASS AVE |
| City | KETCHIKAN |
| State | AK |
| Zip Code | 99901-5742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154315109 | Kathryn Lynn Price | Family Medicine | 2960 Tongass Ave, Ketchikan, AK 99901-5742 | 2005-09-06 |
| 1427668300 | Morgan Wayne Holmes | Dentist | 2960 Tongass Ave, Ketchikan, AK 99901-5742 | 2020-08-05 |
| 1073177424 | Maxx Ritchie Keizer | Pharmacist | 2960 Tongass Ave, Ketchikan, AK 99901-5742 | 2019-04-30 |
| 1043763824 | Ying Kwok | Dentist | 2960 Tongass Ave, Ketchikan, AK 99901-5742 | 2016-07-28 |
| 1780036491 | Andrea A. Lui | Family Medicine | 2960 Tongass Ave, Ketchikan, AK 99901-5742 | 2016-07-06 |
| 1912370347 | Pamela Lee Rogers | Nurse Practitioner | 2960 Tongass Ave, Ketchikan, AK 99901-5742 | 2015-11-06 |
| 1356745723 | Megan Hanifin | Counselor | 2960 Tongass Ave, Ketchikan, AK 99901-5742 | 2014-10-14 |
| 1396153649 | Ketchikan Indian Corporation | Clinic/Center | 2960 Tongass Ave, Ketchikan, AK 99901-5742 | 2014-07-31 |
| 1427460997 | Gerry Balluta | Case Manager/Care Coordinator | 2960 Tongass Ave, Ketchikan, AK 99901-5742 | 2014-06-02 |
| 1447670393 | Kristin Santroch | Dentist | 2960 Tongass Ave, Ketchikan, AK 99901 | 2014-04-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992314215 | Residential Youth Care, Inc. | Community/Behavioral Health | 2442 Tongass Avenue, Ketchikan, AK 99901 | 2020-07-23 |
| 1316563026 | Residential Youth Care, Inc. | Community/Behavioral Health | 606 Hill Road, Ketchikan, AK 99901 | 2020-06-18 |
| 1043836851 | Residential Youth Care, Inc. | Community/Behavioral Health | 2514 1st Avenue, Ketchikan, AK 99901 | 2020-06-18 |
| 1215553029 | Residential Youth Care, Inc. | Community/Behavioral Health | 2951 Baranof Avenue, Ketchikan, AK 99901 | 2020-06-18 |
| 1174159222 | Helene Rae Simpson | Behavior Technician | 201 Deermont St, Ketchikan, AK 99901 | 2020-03-20 |
| 1003295155 | Suzanne Webb | Massage Therapist | 602 Dock St Ste 106, Ketchikan, AK 99901 | 2015-05-22 |
| 1093194342 | Kate Mortensen | Case Manager/Care Coordinator | 2690 Tongass Ave, Ketchikan, AK 99901 | 2015-05-20 |
| 1578879631 | Thomas Peter Ryan | Social Worker | 320 Bawden St. #318, Ketchikan, AK 99901 | 2010-08-27 |
| 1689820979 | Akeela Inc | Community Based Residential Treatment Facility, Mental Illness | 3050 Fifth Ave, Ketchikan, AK 99901 | 2008-08-18 |
| 1750565438 | Susan Marie Swift | Nurse Practitioner | 21 Jefferson Way, Suite 202, Psychiatry, Ketchikan, AK 99901 | 2007-12-18 |
| Find all providers in zip 99901 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306909197 | Residential Youth Care Inc | Clinic/Center | 2514 1st Ave, Ketchikan, AK 99901-5804 | 2006-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962002113 | Volunteers of America Alaska, Central Ms | Clinic/Center | 1405 E St, Anchorage, AK 99501-5047 | 2020-10-27 |
| 1811597065 | Volunteers of America Alaska, West Hs | Clinic/Center | 1700 Hillcrest Dr, Anchorage, AK 99517-1347 | 2020-10-27 |
| 1578163721 | Volunteers of America Alaska, Romig Ms | Clinic/Center | 2500 Minnesota Dr, Anchorage, AK 99503-2384 | 2020-10-27 |
| 1295335446 | Volunteers of America Alaska, Tyson Es | Clinic/Center | 2801 Richmond Ave, Anchorage, AK 99508-1099 | 2020-10-27 |
| 1407466204 | Southcentral Foundation | Clinic/Center | 11495 N Callison St, Sutton, AK 99674 | 2020-08-06 |
| 1972120210 | Denali Family Services | Clinic/Center | 291 E Swanson Ave, Wasilla, AK 99654-7004 | 2020-07-02 |
| 1063033959 | Volunteers of America Alaska, Bartlett Hs | Clinic/Center | 1101 Golden Bear Dr, Anchorage, AK 99504-6120 | 2020-05-01 |
| 1427679307 | Volunteers of America Alaska, Benny Ss | Clinic/Center | 4515 Campbell Airstrip Rd, Anchorage, AK 99507-1267 | 2020-05-01 |
| 1396366290 | Volunteers of America Alaska, East Hs | Clinic/Center | 4025 E Northern Lights Blvd, Anchorage, AK 99508-3588 | 2020-05-01 |
| 1558991323 | Hatcher Pass Counseling and Consultation LLC | Clinic/Center | 720 E Evergreen Ave Ste B, Palmer, AK 99645-6660 | 2020-01-21 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on KETCHIKAN INDIAN CORPORATION.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.