NPIMap

Organization Active NPI

Kic Tribal Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Ketchikan, AK
National Provider Identifier
1043533946
Registry record updated Mar 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
10728 Issued in AK
Legal business name
KIC TRIBAL HEALTH CLINIC
Practice address
2960 Tongass Ave
Ketchikan, AK 99901-5742
Phone
(907) 228-4900
Fax
(907) 228-4905
NPI assigned
Mar 5, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2010

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

Authorized official

Name
Ms. Marsha M Ramirez, CNA
Title
Diabetes Coordinator
Phone
(907) 228-4900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 10728 AK Primary

Addresses

Primary practice location

2960 Tongass Ave
Ketchikan, AK 99901-5742

Mailing address

2960 Tongass Ave
Ketchikan, AK 99901-5742
Phone (907) 228-4900

National Provider Directory

National Provider Directory
Tax ID family
Kicthc Behavioral Health Department7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1267747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267747200000",
    "number": "1043533946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2960 TONGASS AVE",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999015742",
            "telephone_number": "907-228-4900",
            "fax_number": "907-228-4905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 TONGASS AVE",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999015742",
            "telephone_number": "907-228-4900",
            "fax_number": "907-228-4905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIC TRIBAL HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-05",
        "last_updated": "2010-03-05",
        "status": "A",
        "authorized_official_last_name": "RAMIREZ",
        "authorized_official_first_name": "MARSHA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIABETES COORDINATOR",
        "authorized_official_telephone_number": "907-228-4900",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CNA"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "AK",
            "license": "10728",
            "primary": true
        }
    ],
    "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 Mar 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.