Ketchikan Gateway Borough

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

2025 Issued in AK

Legal business name

KETCHIKAN GATEWAY BOROUGH

Practice address

1900 1St Ave
Suite 118
Ketchikan, AK 99901

Phone

(907) 247-5521

Fax

(907) 247-6625

NPI assigned

Jan 30, 2007

Organization subpart

No

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

Authorized official

Name

Charlanne Thomas

Title

Bourough Treasurer

Phone

(907) 228-6613

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

Locations

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353369600000",
    "number": "1053458257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3510",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983833510",
            "telephone_number": "360-394-7030",
            "fax_number": "360-394-7097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 1ST AVE",
            "address_2": "SUITE 118",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "99901",
            "telephone_number": "907-247-5521",
            "fax_number": "907-247-6625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KETCHIKAN GATEWAY BOROUGH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2012-11-20",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "CHARLANNE",
        "authorized_official_title_or_position": "BOUROUGH TREASURER",
        "authorized_official_telephone_number": "907-228-6613"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "AK",
            "license": "2025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GA4626",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alice Ketah
• Ketchikan Dental
• Ketchikan Emergency Physicians, LLC
• Ketchikan Eye Care Center, L.L.C.
• Ketchikan Functional Medicine
• Ketchikan Gateway Borough School District
• Ketchikan Indian Community
• Ketchikan Indian Corporation
• Ketchikan Indian Corporation
• Ketchikan Indian Corporation

• Land Ambulance in Ketchikan, AK
• Providers in Ketchikan, AK by specialty
• Land Ambulance in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; 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.