Denali Mesa Corporation

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

DENALI MESA CORPORATION

Practice address

260 Caviar St
Ste a
Kenai, AK 99611-7738

Phone

(907) 258-8618

Fax

(907) 563-9291

NPI assigned

Mar 12, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Patrick Kinnebrew

Title

Vice President

Phone

(907) 258-8618

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Frontier Therapy Services Doing business as

Locations

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216166400000",
    "number": "1215069414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 E DOWLING RD",
            "address_2": "STE 26",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995181424",
            "telephone_number": "907-258-8618",
            "fax_number": "907-563-9291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 CAVIAR ST",
            "address_2": "STE A",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996117738",
            "telephone_number": "907-258-8618",
            "fax_number": "907-563-9291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENALI MESA CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2008-07-16",
        "status": "A",
        "authorized_official_last_name": "KINNEBREW",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "907-258-8618",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TC6852",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR",
            "identifier": "193978502",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Frontier Therapy Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nathaniel John Davis, CDC1
• Gregory Debnam, P.T.A.
• Amanda Deboer, RDH
• Deborah McCarthy
• Hannah Deibert, RDH
• Laura Denny
• Seth Jed Desiena
• Shandalyn Rayne Devolld
• Wendy Kay Dial
• James Edwin Dickey, FNP

• Physical Therapist in Kenai, AK
• Providers in Kenai, AK by specialty
• Physical Therapist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; 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.