NPIMap

Organization Active NPI

Calm Harbor Health Clinic

  • Family Nurse Practitioner
  • Ketchikan, AK
National Provider Identifier
1124593512
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
CALM HARBOR HEALTH CLINIC
Practice address
3528 Tongass Ave
Ketchikan, AK 99901-5635
Phone
(907) 617-4481
NPI assigned
Oct 11, 2018
Last updated
Mar 4, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2021

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

Authorized official

Name
Mrs. Marina Judith-Rowe McIntyre, FNPNPI 1336570506
Title
Owner
Phone
(907) 617-4481

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

3528 Tongass Ave
Ketchikan, AK 99901-5635

Mailing address

3528 Tongass Ave
Ketchikan, AK 99901-5635
Phone (907) 617-4481

Other names 1

  • Calm Harbor Health Clinic Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1539216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614816000000",
    "number": "1124593512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3528 TONGASS AVE",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999015635",
            "telephone_number": "907-617-4481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3528 TONGASS AVE",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999015635",
            "telephone_number": "907-617-4481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALM HARBOR HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-11",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A",
        "authorized_official_last_name": "MCINTYRE",
        "authorized_official_first_name": "MARINA",
        "authorized_official_middle_name": "JUDITH-ROWE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-617-4481",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Calm Harbor Health Clinic",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Calm Harbor Health Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Calm Harbor Health Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 4, 2021; 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.