KACHEMAK BAY MEDICAL CLINIC (NPI# 1770651762) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770651762 |
| Entity Type | Organization |
| Organization Name | KACHEMAK BAY MEDICAL CLINIC |
| Practice Address |
4201 Bartlett St Ste 202 Homer AK 99603-7004 |
| Practice Telephone | 9072357000 |
| Practice Fax Number | 9072354050 |
| Mailing Telephone | 9072357000 |
| Mailing Fax Number | 9072354050 |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. PAUL DAVID RAYMOND (PRESIDENT) |
| Authorized Official Telephone | 9072357000 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
4201 BARTLETT ST STE 202 |
| City | HOMER |
| State | AK |
| Zip Code | 99603-7004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619045267 | Ann Feige Anderson | Physician Assistant | 4201 Bartlett St Ste 202, Homer, AK 99603-7015 | 2006-12-01 |
| 1790853331 | Nancy Marlene Mackey | Physician Assistant | 4201 Bartlett St Ste 202, Homer, AK 99603-7004 | 2006-12-01 |
| 1912075920 | Paul D Raymond | Family Medicine | 4201 Bartlett St Ste 202, Homer, AK 99603-7004 | 2006-11-30 |
| 1760550776 | Kenneth S Hahn | Family Medicine | 4201 Bartlett St Ste 202, Homer, AK 99603-7004 | 2006-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518572387 | Morgan Dwyer | Counselor | 51310 Timber Bay Ct, Homer, AK 99603 | 2020-09-09 |
| 1346859824 | John George Hetrick | Counselor | 51310 Timber Bay Ct., Homer, AK 99603 | 2020-07-30 |
| 1093352502 | Katieostrommd | Obstetrics & Gynecology | 205 W Fairview, Homer, AK 99603 | 2019-12-03 |
| 1023651965 | Melissa Elizabeth Malcolm | Physical Therapy Assistant | 4107 Hohe Ave, Homer, AK 99603 | 2019-10-23 |
| 1184143620 | Homer Birth and Wellness Center | Clinic/Center | 3902 Shelford Street, Homer, AK 99603 | 2017-09-15 |
| 1588913271 | Sharon Marie Gorman | Registered Nurse | 3959 Ben Walters, Homer, AK 99603 | 2012-09-10 |
| 1477802197 | Aldergrove Assisted Living | Community Based Residential Treatment Facility, Mental Illness | 41045 Denny Lane, Homer, AK 99603 | 2012-09-10 |
| 1194087551 | Stephen Michael Mueller | Pharmacist | 3858 Lake Street, Suite #5, Lakeside Mall, Homer, AK 99603 | 2012-06-12 |
| 1962778001 | Homer Dental Center Inc | Dentist | 4014 Lake St., Ste 210, Homer, AK 99603 | 2012-03-22 |
| 1346544368 | William R Easton | General Practice | 2495 Bayridge Rd, Homer, AK 99603 | 2011-01-05 |
| Find all providers in zip 99603 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659394898 | Tim W Scheffel | Family Medicine | 3179 Lake St, Homer, AK 99603-7908 | 2006-07-26 |
| 1063438588 | Donald Keith Haynes | Family Medicine | 912 West Main St., Homer, LA 71040-4228 | 2006-07-15 |
| 1306882360 | David Robert Downey | Family Medicine | 203 W Pioneer Ave Ste 3, Homer, AK 99603-7527 | 2006-06-20 |
| 1932104098 | Teresa K Johnson | Family Medicine | 4136 Bartlett St, Homer, AK 99603-7001 | 2005-06-16 |
| 1609258680 | Gaurav Jaswal | Family Medicine | 82 Copeland Ave, Homer, NY 13077-1528 | 2015-06-25 |
| 1780013532 | Christy Lee Martinez | Family Medicine | 4136 Bartlett St, Homer, AK 99603-7001 | 2013-11-02 |
| 1992091151 | Christina Marie Tuomi | Family Medicine | 4136 Bartlett St, Homer, AK 99603-7001 | 2011-06-24 |
| 1356563837 | Joshua D Munro | Family Medicine | 420 S Hillsdale St, Homer, MI 49245-1248 | 2007-05-03 |
| 1235264409 | Randall Habecker Wiest | Family Medicine | 4136 Bartlett St, Homer Medical Clinic, Homer, AK 99603-7001 | 2007-02-21 |
| 1043352214 | Paul Leo Eneboe | Family Medicine | 4136 Bartlett St, Homer Medical Clinic, Homer, AK 99603-7015 | 2007-02-13 |
| Find all providers in HOMER | ||||
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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.