Kodiak Area Native Association

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Legal business name

KODIAK AREA NATIVE ASSOCIATION

Practice address

325 Carolyn St
Kodiak, AK 99615

Phone

(907) 486-9870

NPI assigned

Dec 15, 2023

Organization subpart

No

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

Authorized official

Name

Candice Jacobs

Title

BH Compliance Specialist

Phone

(907) 486-9870

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Daniel Aga

  • Peer Specialist
  • Kodiak, AK
  • NPI 1982472387
  NPD
• Alison Marie Bravo

  • Peer Specialist
  • Kodiak, AK
  • NPI 1730978990
  NPD

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

{
    "created_epoch": "1702598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702598400000",
    "number": "1225806607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3449 E REZANOF DR",
            "city": "KODIAK",
            "state": "AK",
            "postal_code": "996156952",
            "telephone_number": "907-486-9870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 CAROLYN ST",
            "city": "KODIAK",
            "state": "AK",
            "postal_code": "99615",
            "telephone_number": "907-486-9870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KODIAK AREA NATIVE ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-15",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-13",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "CANDICE",
        "authorized_official_title_or_position": "BH COMPLIANCE SPECIALIST",
        "authorized_official_telephone_number": "907-486-9870"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fayra Mae Klier
• Carolyn Knowles
• Kodiak Area Native Association
• Kodiak Area Native Association
• Kodiak Area Native Association
• Kodiak Area Native Association
• Kodiak Area Native Association
• Kodiak Area Native Association
• Kodiak Area Native Association Pharmacy
• Kodiak Birth and Wellness, LLC

• Peer Specialist in Kodiak, AK
• Providers in Kodiak, AK by specialty
• Peer Specialist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2023; 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.