Arctic Chiropractic and Physical Medicine Ketchikan
Organization Active NPI Chiropractor · Ketchikan, AK
NPI 1023463577 · NPPES record last updated May 24, 2016
Key facts
- NPI
- 1023463577
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 468 (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
- Organization subpart
- No
Authorized official
- Name
- James Chavis, D.C.
- Title
- Owner
- Phone
- (907) 888-9032
Practitioners 6
-
Holli Lanea Flippo, DPT
-
Steven Bennett, LMT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160623002496 | AK | Part B Supplier - Clinic/Group Practice | 4082905989 |
Receives reassigned benefits from 3 practitioners Practice locations: Ketchikan, AK |
National Provider Directory
Locations
2050 Sea Level Dr
Ste 106
Ketchikan, AK 99901
Phone (907) 225-7246
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 468 | AK | Yes |
| Physical Therapist |
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
Other providers in Ketchikan, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 24, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.