Kenai Family Practice LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4040 Issued in AK

Legal business name

KENAI FAMILY PRACTICE LLC

Practice address

135 Bidarka St
Suite 101
Kenai, AK 99611-7741

Phone

(907) 335-0034

Fax

(907) 335-0064

NPI assigned

Sep 28, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Terri L Elliott, D.O.NPI 1316932031

Title

Owner

Phone

(907) 335-0034

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

Practitioners 3

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

• Terri Lee Elliott, D.O.

  • Family Medicine Physician
  • Kenai, AK
  • NPI 1316932031
  NPD (past) Authorized official
• Christine M Babcock, A.N.P.

  • Nurse Practitioner
  • Kenai, AK
  • NPI 1013902758
  NPD (past)
• Jodi Michelle Moore, PA-C

  • Physician Assistant
  • Fort Bragg, NC
  • NPI 1386794493
  NPD (past)

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

{
    "created_epoch": "1190937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212969600000",
    "number": "1255528733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 BIDARKA ST",
            "address_2": "SUITE 101",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996117741",
            "telephone_number": "907-335-0034",
            "fax_number": "907-335-0064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 BIDARKA ST",
            "address_2": "SUITE 101",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996117741",
            "telephone_number": "907-335-0034",
            "fax_number": "907-335-0064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENAI FAMILY PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-28",
        "last_updated": "2008-06-09",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "TERRI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-335-0034",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "4040",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "725",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "AK",
            "license": "175",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP LEGACY",
            "identifier": "K152261",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Karpik
• Megan K. Kato, CCC-SLP
• Sheilah Eileen Kean, RN
• Joseph W Keith, D.C.
• Kenai Anesthesia Associates, LLC
• Kenai Kids Therapy Inc
• Kenai Kids Therapy, Inc
• Kenai Medical Center Inc.
• Kenai Peninsula Community Care Center
• Kenai Peninsula Community Care Emergency

• Family Medicine Physician in Kenai, AK
• Providers in Kenai, AK by specialty
• Family Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.