PEACEHEALTH (NPI# 1235556846) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235556846 |
| Entity Type | Organization |
| Organization Name | PEACEHEALTH |
| Practice Address |
212 Carlanna Lake Rd #204 Ketchikan AK 99901-5642 |
| Mailing Address |
1115 Se 164th Ave Dept 358 Vancouver WA 98683-9324 |
| Practice Telephone | 9072257346 |
| Mailing Telephone | 3607291411 |
| Enumeration Date | 2014-03-20 |
| Last Update Date | 2014-03-20 |
| Authorized Official Name | LORI MCCOY (PROVIDER ENROLLMENT SPECIALIST) |
| Authorized Official Telephone | 3607291411 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 5790 | AK | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255977591 | Peacehealth | Durable Medical Equipment & Medical Supplies | 625 9th Ave Ste 120, Longview, WA 98632-2465 | 2019-11-21 |
| 1184106437 | Peacehealth | Durable Medical Equipment & Medical Supplies | Triangle Mall Suite 16 1015 Ocean Beach Hwy, Longview, WA 98632 | 2018-09-04 |
| 1669766457 | Peacehealth | General Acute Care Hospital | 787 Woodland Acres Ln, Eugene, OR 97402-9378 | 2011-06-09 |
| 1760427082 | Peacehealth | Home Health | 126 Washington St, Ketchikan, AK 99901-5930 | 2006-06-19 |
| 1912957986 | Peacehealth | Clinical Medical Laboratory | 123 International Way, Springfield, OR 97477-1047 | 2006-05-11 |
| 1083672273 | Peacehealth | Rehabilitation Unit | 809 E Chestnut St, Bellingham, WA 98225-5221 | 2006-05-04 |
| 1447217559 | Peacehealth | Hospice, Inpatient | 2800 Douglas Avenue, Bellingham, WA 98225 | 2006-05-01 |
| 1215918719 | Peacehealth | Hospice Care, Community Based | 2230 Kingwood Street, Florence, OR 97439-9470 | 2005-11-10 |
| 1225019011 | Peacehealth | Home Health | 2230 Kingwood St, Florence, OR 97439-9464 | 2005-11-08 |
| 1346237971 | Peacehealth | General Acute Care Hospital | 1255 Hilyard St, Eugene, OR 97401-3718 | 2005-09-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PEACEHEALTH | 1115 Se 164th Avenue, Vancouver, WA 98683-9324 |
| Washington State Corporations | PEACEHEALTH | 1115 Se 164th Ave Dept. 302, Vancouver, WA 98683 |
| Oregon Corporations, Companies and Business Names | PEACEHEALTH | 1115 Se 164th Ave Dept 302, Vancouver, WA 98683 |
| Oregon Corporations, Companies and Business Names | PEACEHEALTH - COTTAGE GROVE | 1515 Village Dr, Cottage Grove, OR 97424 |
| Washington State Corporations | PEACEHEALTH ASC BELLINGHAM, LLC | 1115 Se 164th Ave, Dept 302, Vancouver, WA 98683-9324 |
| Oregon Corporations, Companies and Business Names | PEACEHEALTH COTTAGE GROVE COMMUNITY MEDICAL CENTER | 1515 Village Dr, Cottage Grove, OR 97424 |
| Oregon Corporations, Companies and Business Names | PEACEHEALTH COTTAGE GROVE COMMUNITY MEDICAL CENTER FOUNDATION | 1515 Village Dr, Cottage Grove, OR 97424 |
| Oregon Corporations, Companies and Business Names | PEACEHEALTH COTTAGE GROVE COMMUNITY MEDICAL CENTER SWING | 1515 Village Drive, Cottage Grove, OR 97424 |
| Oregon Corporations, Companies and Business Names | PEACEHEALTH HOSPITAL MEDICINE | 3333 Riverbend Dr, Springfield, OR 97477 |
| Oregon Corporations, Companies and Business Names | PEACEHEALTH LABORATORIES | 123 International Way, Springfield, OR 97477 |
| Street Address |
212 CARLANNA LAKE RD #204 |
| City | KETCHIKAN |
| State | AK |
| Zip Code | 99901-5642 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770645350 | Louis E. Kleager | Otolaryngology | 212 Carlanna Lake Rd, Suite 201, Ketchikan, AK 99901-5613 | 2006-12-13 |
| 1538458138 | Andrew Briggs Sanders | Family Medicine | 212 Carlanna Lake Rd, Suite 100, Ketchikan, AK 99901-5642 | 2011-04-04 |
| 1972810281 | Linda Diane Gilson | Nurse Practitioner | 212 Carlanna Lake Rd, 100, Ketchikan, AK 99901-5658 | 2010-09-08 |
| 1861661670 | Louis E Kleager Md Ent PC | Otolaryngology | 212 Carlanna Lake Rd, Ketchikan, AK 99901-5613 | 2008-02-26 |
| 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 | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972547628 | Harrison Emory Guy Burman | Surgery | 3100 Tongass Ave, Ketchikan, AK 99901 | 2006-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316407992 | Center for Vein Restoration Ak LLC | Surgery | 2550 Denali St Ste 1307, Anchorage, AK 99503-2752 | 2019-03-21 |
| 1184002131 | Thomas Knolmayer Md LLC | Surgery | 19510 S Mitkof Loop, Eagle River, AK 99577-8669 | 2015-05-11 |
| 1205167483 | Paul Sayer M.d. Prof Corp | Surgery | 4209 Hohe St, Homer, AK 99603-7010 | 2010-01-27 |
| 1184954265 | Catherine Anne Morrison | Surgery | 3220 Providence Dr Ste 3080, Anchorage, AK 99508-4679 | 2010-01-12 |
| 1649419508 | Peninsula Surgical Solutions, LLC | Surgery | 254 N Binkley St, Soldotna, AK 99669-7522 | 2009-02-16 |
| 1396915849 | David A Miller, Md Inc | Surgery | 3268 Hospital Dr Ste C, Juneau, AK 99801-7800 | 2008-03-11 |
| 1780725820 | Cathy Jane Brenner | Surgery | 20217 Riverside Dr, Eagle River, AK 99577-8856 | 2007-02-10 |
| 1912044264 | James Paul Sayer | Surgery | 4209 Hohe Street, Homer, AK 99603 | 2007-01-30 |
| 1679627566 | Alyeska Surgery and Urology Inc | Surgery | 1305 21st Ave, Ste 101, Fairbanks, AK 99701-6022 | 2007-01-22 |
| 1578612578 | Rene L Alvarez | Surgery | 104 East Fairview Ave, Homer, AK 99603 | 2007-01-09 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PEACEHEALTH.
| 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.