City of Kodiak

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

6200 Issued in AK

Legal business name

CITY OF KODIAK

Doing business as

City of Kodiak Ambulance Service

Practice address

219 Lower Mill Bay Rd
Kodiak, AK 99615-6352

Phone

(907) 486-8657

Fax

(907) 486-8600

NPI assigned

May 22, 2007

Last updated

Aug 11, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Victoria A Ellis

Title

Ambulance Clerk

Phone

(907) 486-8656

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• City of Kodiak Ambulance Service Doing business as

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": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754870400000",
    "number": "1174733182",
    "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": "360-394-7020",
            "fax_number": "360-394-7099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 LOWER MILL BAY RD",
            "city": "KODIAK",
            "state": "AK",
            "postal_code": "996156352",
            "telephone_number": "907-486-8657",
            "fax_number": "907-486-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF KODIAK",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "AMBULANCE CLERK",
        "authorized_official_telephone_number": "907-486-8656"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "AK",
            "license": "6200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GA0100",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "City of Kodiak Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sam J Chelmo, MD
• Christie Ann Chernoff, MA CCC SLP
• Heidi Sue Christensen
• Sabrina Renee Christiansen, RN
• Fawn Chya
• Tracey Elizabeth Claveau
• Blanca Claypool, LMT
• Cynthia Clogston
• Tina Clumpner, M.S., CCC-SLP
• Aaron Scott Coggins

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; 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.