KENAI SPINE LLC (NPI# 1497002968) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497002968 |
| Entity Type | Organization |
| Organization Name | KENAI SPINE LLC |
| Practice Address |
291 N Fireweed St Soldotna AK 99669-7540 |
| Practice Telephone | 9072605455 |
| Practice Fax Number | 9072620832 |
| Mailing Telephone | 9072605455 |
| Mailing Fax Number | 9072620832 |
| Enumeration Date | 2012-08-14 |
| Last Update Date | 2012-08-14 |
| Authorized Official Name | DR. STEVEN CRAIG HUMPHREYS (OWNER) |
| Authorized Official Telephone | 9072605455 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
6826 | AK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | MD9678 | 05 |
| Street Address |
291 N FIREWEED ST |
| City | SOLDOTNA |
| State | AK |
| Zip Code | 99669-7540 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891790184 | Independence Healthcare PC | Clinic/Center | 291 N Fireweed St, Soldotna, AK 99669-7540 | 2005-06-14 |
| 1386206647 | Sarah Allen Phillips | Nurse Practitioner | 291 N Fireweed St, Soldotna, AK 99669-7540 | 2019-07-07 |
| 1083171342 | Aer Medical LLC | Internal Medicine | 291 N Fireweed St, Soldotna, AK 99669-7540 | 2019-02-22 |
| 1245771864 | Independence Imaging | Radiology | 291 N Fireweed St, Soldotna, AK 99669-7540 | 2017-03-15 |
| 1427598978 | Independence Healthcare | Radiology | 291 N Fireweed St, Soldotna, AK 99669-7540 | 2017-03-02 |
| 1811192495 | Alvaro Enrique Rosales | Internal Medicine | 291 N Fireweed St, Soldotna, AK 99669-7540 | 2007-06-15 |
| 1669477790 | Henry G Krull | Orthopaedic Surgery | 291 N Fireweed St, Soldotna, AK 99669-7540 | 2005-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881201226 | Kyle Arron Shassetz | Counselor | 43335 K-beach Rd., Soldotna, AK 99669 | 2020-09-29 |
| 1720614993 | Peninsula Instacare | Clinic/Center | 34581 Kenai Spur Hwy, Suite 1, Soldotna, AK 99669 | 2020-03-19 |
| 1871141077 | Alaine Viola Lagasse | Counselor | Kenai Vet Center, 43299 Kalifornsky Beach Road Ste 4, Soldotna, AK 99669 | 2019-08-30 |
| 1962970574 | Ryder R Storm | Behavior Technician | 338800 Community College Drive, Suite 1, Soldotna, AK 99669 | 2018-11-13 |
| 1356821540 | Tanecia Webster | Nurse Practitioner | 36570 Kenai Spur Hwy, Ste 103a, Soldotna, AK 99669 | 2018-08-16 |
| 1821519869 | Theresa Napolitano | Case Manager/Care Coordinator | 35477 Kenai Spur Hwy Suite 203, Soldotna, AK 99669 | 2017-06-29 |
| 1689048282 | Jeanne Bignell | Licensed Practical Nurse | 35020 Alaskan View Lane, Soldotna, AK 99669 | 2015-11-19 |
| 1952786105 | Ian Charles Mcmullen | Pharmacist | 44001 Sterling Highway, Soldotna, AK 99669 | 2015-07-29 |
| 1841679933 | Lana Clymer | Case Manager/Care Coordinator | 22994 Kalifornsky Beach Rd, Soldotna, AK 99669 | 2015-05-22 |
| 1861800773 | Phillip Bruce | Physical Therapy Assistant | 35105 Kenai Spury Hwy, Suite A, Soldotna, AK 99669 | 2014-07-24 |
| Find all providers in zip 99669 | ||||
| Taxonomy Code | 207XS0117X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Surgery of the Spine |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437339454 | Brent M. Adcox | Orthopaedic Surgery | 4201 Bartlett St Ste 201, Homer, AK 99603-7015 | 2007-11-07 |
| 1902834153 | Upshur M Spencer | Orthopaedic Surgery | 3831 Piper St, Suite S-220, Anchorage, AK 99508-4672 | 2006-06-28 |
| 1922036201 | Davis C Peterson | Orthopaedic Surgery | 3831 Piper St, Suite S-220, Anchorage, AK 99508-4672 | 2006-06-28 |
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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.