Kic Tribal Health Clinic

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

11131 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 9, 2010

Organization subpart

No

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

Authorized official

Name

Debbie Patton

Title

General Manager

Phone

(907) 228-4941

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1268092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268092800000",
    "number": "1124341896",
    "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": "2010-03-09",
        "last_updated": "2010-03-09",
        "status": "A",
        "authorized_official_last_name": "PATTON",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "907-228-4941"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "AK",
            "license": "11131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ketchikan Indian Corporation
• Ketchikan Indian Corporation
• Ketchikan Physical Therapy, LLC
• Bobbi Jo Keuken, MA
• Kic Tribal Health Clinic
• Kic Tribal Health Clinic
• Kic/THC Behavioral Health Department
• Collin Kimball
• Krista Kimball
• Sheila Lynne Kimble-Haas, C.N.M., CFNP

• Health Service Clinic/Center in Ketchikan, AK
• Providers in Ketchikan, AK by specialty
• Health Service Clinic/Center in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.