INTEGRATED SUPPORT COMMAND KODIAK (NPI# 1720064884) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720064884 |
| Entity Type | Organization |
| Organization Name | INTEGRATED SUPPORT COMMAND KODIAK |
| Other Organization Name | ROCKMORE-KING CLINIC |
| Practice Address |
Building N46 Cape Sarichef Kodiak AK 99619-5002 |
| Mailing Address |
Building N 46 Cape Sarlchef Kodiak AK 99619-5002 |
| Practice Telephone | 9074875757 |
| Practice Fax Number | 9074875360 |
| Mailing Telephone | 9074875757 |
| Mailing Fax Number | 9074875360 |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2008-07-28 |
| Authorized Official Name | TODD LANE EMERSON (CLINIC ADMINISTRATOR) |
| Authorized Official Telephone | 9074875757 |
| Authorized Official Credential | CLINIC ADMINISTR |
| Is Organization Subpart | Y |
| Parent Organization Name | US COAST GUARD |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QD0000X |
Clinic/Center Specialization: Dental |
AK | Ambulatory Health Care Facilities | |
| N | 291900000X | Military Clinical Medical Laboratory | 02D0666660 | AK | Laboratories |
| N | 332000000X | Military/U.S. Coast Guard Pharmacy | NCPDP0202414 | AK | Suppliers |
| Y | 261Q00000X | Clinic/Center | AK | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Rockmore-King Clinic | Doing Business As Name - Organization |
| Street Address |
BUILDING N46 CAPE SARICHEF |
| City | KODIAK |
| State | AK |
| Zip Code | 99619-5002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013088921 | Andrew Jackson Shields | Technician, Other | Building N46 Cape Sarichef, Kodiak, AZ 99619 | 2006-11-13 |
| 1609947514 | Christopher Edwin Burnside | Technician, Other | Building N46 Cape Sarichef, Kodiak, AK 99619 | 2006-11-13 |
| 1366513277 | Jason Alexander Sessoms | Technician, Other | Building N46 Cape Sarichef, Kodiak, AK 99619 | 2006-11-13 |
| 1790707339 | Jerritt Gerry Green | Technician, Other | Building N46 Cape Sarichef, Kodiak, AK 99619-5002 | 2006-07-24 |
| 1073590220 | Maricruz Yanelly Duran Rodriquez | Technician, Other | Building N46 Cape Sarichef, Kodiak, AK 99619 | 2005-12-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255832069 | Johnathan Gunn | Military Health Care Provider | 200 Albatross Ave. Bldg N46, P.o. Box 190651, Kodiak, AK 99619 | 2018-02-27 |
| 1124416151 | Katelyn Braswell | Technician, Other | Base Kodiak Bldg N46, Kodiak, AK 99619 | 2014-12-29 |
| 1033517206 | United States Coast Guard | Clinic/Center | Base Kodiak Building N-46, Kodiak, AK 99619 | 2014-12-19 |
| 1891043642 | Lara Alohalani Schiffer | Technician, Other | N46 Cape Sarichef Rd, Rockmore King Clinic, Kodiak, AK 99619 | 2012-08-28 |
| 1114275807 | Bonnie Reilly | Technician, Other | Sarichef Rd Bldg N-46, Hswl Rockmore-king Clinic, Kodiak, AK 99619 | 2012-08-28 |
| 1730437427 | April Lynn Fieste | Technician, Health Information | Cape Sarichef Bldg N46, Uscg Hswl Rockmore King Clinic, Kodiak, AK 99619 | 2012-08-28 |
| 1568710259 | Zachary Xaiver Love | Technician, Other | Cape Sarichef Rd. Bldg N46, Hswl Rockmore-king Clinic, Kodiak, AK 99619 | 2012-08-28 |
| 1518159672 | Regan Enlow-moir | Dental Hygienist | Building N46, Cape Sarichef Street, Kodiak, AK 99619 | 2007-08-13 |
| 1659416857 | Kristy A Campbell | Technician, Other | Cape Sarichef Rd Bldg N46, Hswl Fo Kodiak, Kodiak, AK 99619 | 2007-02-21 |
| 1689727539 | Elaine A. Jergons | Military Health Care Provider | Building N-46, Kodiak, AK 99619 | 2007-01-22 |
| Find all providers in zip 99619 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811596026 | Pivotal Care Partnership | Clinic/Center | 2925 Debarr Rd Ste 199, Anchorage, AK 99508-2959 | 2020-10-19 |
| 1942807862 | Turning Leaf Literacy Center, LLC | Clinic/Center | 690 E Susitna Ave, Wasilla, AK 99654-8124 | 2020-10-04 |
| 1982237921 | Revive Aesthetics & Spa Wasilla, LLC | Clinic/Center | 1175 N Leatherleaf Loop Ste F, Wasilla, AK 99654-6527 | 2020-02-18 |
| 1821560160 | Ideal Option, Pllc | Clinic/Center | 3159 Tongass Ave, Ketchikan, AK 99901-5745 | 2018-12-27 |
| 1902389943 | Ideal Option, Pllc | Clinic/Center | 8585 Old Dairy Rd Ste 200, Juneau, AK 99801-8094 | 2018-09-14 |
| 1063911287 | Ideal Option, Pllc | Clinic/Center | 416 Frontage Rd # 400, Kenai, AK 99611-7770 | 2018-02-02 |
| 1255857876 | Vera Whole Health | Clinic/Center | 582 E 36th Ave Ste 203, Anchorage, AK 99503-4138 | 2017-08-15 |
| 1871020123 | Coburn Health Consulting LLC | Clinic/Center | 4401 Business Park Blvd # N-26, Anchorage, AK 99503-7172 | 2017-05-17 |
| 1063958452 | Southeast Alaska Regional Health Consortium | Clinic/Center | Cannery Site, Excursion Inlet, AK 99850 | 2017-01-10 |
| 1962948356 | Southeast Alaska Regional Health Consortium | Clinic/Center | Community Building, Port Protection, AK 99950 | 2017-01-10 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on INTEGRATED SUPPORT COMMAND KODIAK.
| 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.