Individual provider Active NPI

Helen Rose Klein, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Ketchikan, AK
National Provider Identifier
1376613208
Registry record updated Apr 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
551 Issued in AK
Practice address
3524 Tongass Ave
Ketchikan, AK 99901-5635
Phone
(907) 225-9830
Fax
(907) 225-9840
NPI assigned
Nov 8, 2006
Last updated
Apr 27, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 551 AK Primary

Addresses

Primary practice location

3524 Tongass Ave
Ketchikan, AK 99901-5635

Mailing address

PO Box 8061
Ketchikan, AK 99901-3061
Phone (907) 247-8061

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120827000478 AK Practitioner - Nurse Practitioner 2264689256 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Health Clinic LLCGroup PAC ID 4587973946, 3 clinicians

Practice addresses (Care Compare)

3524 Tongass Ave
Ketchikan, AK 99901-5635
Phone (907) 225-6355

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.57 of 100Reported as group
Quality
93.49
Promoting interoperability
100
Improvement activities
40
Cost
61.74

Merit-based Incentive Payment System (MIPS)

Final score
79.12 of 100Reported as group
Quality
81.91
Promoting interoperability
100
Improvement activities
40
Cost
40.93

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
551AKMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Health Clinic, LLC Family CurrentSince Nov 2, 2015 Accepting new patients

Locations

3524 Tongass Ave
Ketchikan, AK 99901
Phone (907) 225-6355

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335484800000",
    "number": "1376613208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8061",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999013061",
            "telephone_number": "907-247-8061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3524 TONGASS AVE",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999015635",
            "telephone_number": "907-225-9830",
            "fax_number": "907-225-9840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEIN",
        "first_name": "HELEN",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2012-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ketchikan, AK

Sources for this page

Verify at the official NPI Registry.