Kenaitze Indian Tribe
Organization Active NPI Federally Qualified Health Center (FQHC) · Soldotna, AK
NPI 1194603076 · NPPES record last updated Aug 26, 2025
Key facts
- NPI
- 1194603076
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- KENAITZE INDIAN TRIBE
- Practice address
- 206 W Rockwell Ave
Soldotna, AK 99669-7439 - Phone
- (907) 335-7200
- NPI assigned
- Aug 26, 2025
- Organization subpart
- No
Authorized official
- Name
- Greg Burnett
- Title
- Finance Director
- Phone
- (907) 335-7200
Other NPIs on the same Medicare enrollment 3
Subparts reporting this organization as parent 4
Corporate family (same tax ID) 2
Practitioners 8
-
Lacy Daniel, LPC
-
Lisa Frederickson, O.D.
-
Shana Mickenham, LPC, CDCS, BHP
-
Rebecca Strong, LCSW
-
Wayne Russell Millar, D.D.S.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040325000198 | AK | Part B Supplier - Clinic/Group Practice | 4082506225 |
Receives reassigned benefits from 40 practitioners 3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Kenai, AK; Soldotna, AK |
| O20200127000403 | AK | Part a Provider - Indian Health Services Facility | 4082506225 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Kenai, AK; Soldotna, AK |
National Provider Directory
- Tax ID family
- Kenaitze Indian Tribe
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | |||
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes | ||
| Health Service Clinic/Center | 261QH0100X | |||
| Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 332800000X |
Addresses
Primary practice location
206 W Rockwell Ave
Soldotna, AK 99669-7439
Mailing address
PO Box 988
Kenai, AK 99611-0988
Phone (907) 335-7200
Other names
- Dena'ina Wellness Center Soldotna
Other providers in Soldotna, AK
- Kenai Peninsula Hospice LLC
- Kenai Peninsula Massage Therapy Inc.
- Kenai Peninsula Mental Health LLC
- Kenai Peninsula Urology, LLC
- Kenai River Counseling
- Marissa Kennedy
- Kenneth G Youngberg PC
- Kenneth Owens
- Sandra Jean Kerns
- Lindsey Kerr
All providers in Soldotna, AK · Federally Qualified Health Center (FQHC) in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 26, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.