Organization Active NPI

Chugach Sports Foot and Ankle, LLC

Doing business as Chugach Sports Foot and Ankle

  • Podiatric Clinic/Center
  • Anchorage, AK
National Provider Identifier
1396552964
Registry record updated Sep 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
Legal business name
CHUGACH SPORTS FOOT AND ANKLE, LLC
Doing business as
Chugach Sports Foot and Ankle
Practice address
4100 Lake Otis Pkwy Ste 300
Anchorage, AK 99508-5230
Phone
(907) 931-1726
Fax
(907) 931-9946
NPI assigned
Dec 16, 2024
Last updated
Sep 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2026

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

Authorized official

Name
Jared Kern, DPMNPI 1447424965
Title
Manager
Phone
(907) 931-1726

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatric Clinic/Center 261QP1100X NU Primary
Foot & Ankle Surgery Podiatrist 213ES0103X NU

Addresses

Primary practice location

4100 Lake Otis Pkwy Ste 300
Anchorage, AK 99508-5230

Mailing address

1120 Huffman Rd Ste 24-550
Anchorage, AK 99515-3516

Other practice location 1

1917 Abbott Rd Ste 100
Anchorage, AK 99507-3449
Phone (907) 931-1726

Other names 1

  • Chugach Sports Foot and Ankle Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20241219002477 AK Part B Supplier - Clinic/Group Practice 4981131620 Receives reassigned benefits from 1 practitioner
Practice locations: Anchorage, AK
O20250611003347 AK DME Supplier - Physician - Podiatry 4981131620 Practice locations: Anchorage, AK

National Provider Directory

National Provider Directory

Locations

1120 Huffman Rd
Ste 24550
Anchorage, AK 99515

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1734307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789257600000",
    "number": "1396552964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 HUFFMAN RD STE 24-550",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995153516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 LAKE OTIS PKWY STE 300",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085230",
            "telephone_number": "907-931-1726",
            "fax_number": "907-931-9946"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1917 Abbott Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995073449",
            "country_code": "US",
            "telephone_number": "907-931-1726",
            "fax_number": "907-931-9946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHUGACH SPORTS FOOT AND ANKLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-16",
        "last_updated": "2026-09-13",
        "certification_date": "2026-09-13",
        "status": "A",
        "authorized_official_last_name": "KERN",
        "authorized_official_first_name": "JARED",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "907-931-1726",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chugach Sports Foot and Ankle",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.