KIC TRIBAL HEALTH CLINIC (NPI# 1437471844) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437471844 |
| Entity Type | Organization |
| Organization Name | KIC TRIBAL HEALTH CLINIC |
| Practice Address |
2960 Tongass Ave Ketchikan AK 99901-5742 |
| Practice Telephone | 9072284900 |
| Enumeration Date | 2010-02-26 |
| Last Update Date | 2010-02-26 |
| Authorized Official Name | DEBBIE PATTON (GENERAL MANAGER) |
| Authorized Official Telephone | 9072284900 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QC1500X |
Clinic/Center Specialization: Community Health |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124341896 | Kic Tribal Health Clinic | Clinic/Center | 2960 Tongass Ave, Ketchikan, AK 99901-5742 | 2010-03-09 |
| 1043533946 | Kic Tribal Health Clinic | Clinic/Center | 2960 Tongass Ave, Ketchikan, AK 99901-5742 | 2010-03-05 |
| 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 | 261QC1500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Community Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639652662 | Southcentral Foundation | Clinic/Center | 26341 Eklutna Village Rd, Chugiak, AK 99567-5148 | 2018-09-14 |
| 1881047108 | Aleutian Pribilof Islands Association | Clinic/Center | 111 Lakeview Rd., Nikolski, AK 99638 | 2016-07-21 |
| 1609232040 | Southcentral Foundation | Clinic/Center | 101 Indian Creek Road, Tyonek, AK 99682 | 2016-01-14 |
| 1235595562 | Chitina Traditional Indian Village Council | Clinic/Center | Mile 28.5 Edgerton Hwy, Chitina, AK 99566 | 2015-12-31 |
| 1770953903 | Southcentral Foundation | Clinic/Center | 1 Flight Line Rd, Port Alsworth, AK 99653-9801 | 2015-09-30 |
| 1144699216 | Southcentral Foundation | Clinic/Center | 4030 Salmon Way, Iguigig, AK 99613 | 2015-09-18 |
| 1295104644 | Southcentral Foundation | Clinic/Center | 102 Fireweed Lane, Newhalen, AK 99606 | 2015-09-16 |
| 1952770307 | Southcentral Foundation | Clinic/Center | 2516 Mountain Circle, Pedro Bay, AK 99647 | 2015-09-16 |
| 1205255957 | Front Street Health Center | Clinic/Center | 225 Front St Ste 202, Juneau, AK 99801-1244 | 2014-04-09 |
| 1043632037 | Southcentral Foundation | Clinic/Center | 11495 N Callison Street, Sutton, AK 99674 | 2014-01-10 |
| Find all providers with the same taxonomy | ||||
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| 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.