Organization Active NPI

Arctic Chiropractic and Physical Medicine Ketchikan

  • Chiropractor
  • Ketchikan, AK
National Provider Identifier
1023463577
Registry record updated May 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
468 Issued in AK
Legal business name
ARCTIC CHIROPRACTIC AND PHYSICAL MEDICINE KETCHIKAN
Practice address
2050 Sea Level Dr
Suite 106
Ketchikan, AK 99901-6058
Phone
(907) 790-3371
Fax
(907) 790-2102
NPI assigned
May 3, 2016
Last updated
May 24, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
James Chavis, D.C.NPI 1831433713
Title
Owner
Phone
(907) 888-9032

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 468 AK Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 104600 AK

Addresses

Primary practice location

2050 Sea Level Dr
Suite 106
Ketchikan, AK 99901-6058

Mailing address

2243 Jordan Ave
Juneau, AK 99801-8050
Phone (907) 790-3371

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160623002496 AK Part B Supplier - Clinic/Group Practice 4082905989 Receives reassigned benefits from 3 practitioners
Practice locations: Ketchikan, AK

National Provider Directory

National Provider Directory

Locations

2243 Jordan Ave
Juneau, AK 99801
Phone (907) 790-3371

2050 Sea Level Dr
Ste 106
Ketchikan, AK 99901
Phone (907) 225-7246

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1462233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464048000000",
    "number": "1023463577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2243 JORDAN AVE",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998018050",
            "telephone_number": "907-790-3371",
            "fax_number": "907-790-2102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 SEA LEVEL DR",
            "address_2": "SUITE 106",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999016058",
            "telephone_number": "907-790-3371",
            "fax_number": "907-790-2102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARCTIC CHIROPRACTIC AND PHYSICAL MEDICINE KETCHIKAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-03",
        "last_updated": "2016-05-24",
        "status": "A",
        "authorized_official_last_name": "CHAVIS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-888-9032",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "AK",
            "license": "468",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "104600",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ketchikan, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.