Active NPI
Connie A Kreiss, MD
- Family Medicine Physician
- Sitka, AK
National Provider Identifier
1497892277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 2284
- Practice address
- 222 Tongass Dr
Sitka, AK 99835-9416 - Phone
- (907) 966-2411
- Fax
- (907) 966-8606
- NPI assigned
- Jan 31, 2007
- Last updated
- Apr 20, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 2284 | AK | Primary |
Addresses
Primary practice location
222 Tongass Dr
Sitka, AK 99835-9416
Mailing address
222 Tongass Dr
Sitka, AK 99835-9416
Phone (907) 966-2411
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MD2284 | Medicaid | AK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2284 | AK | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South East Alaska Regional Health Consortium | Past | Accepting new patients | |
| South East Alaska Regional Health Consortium | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Angoon Health Center
- Clinic/Center
- Angoon, AK
- NPI 1215983945
-
dba Pelican Health Clinic
- Clinic/Center
- Pelican, AK
- NPI 1659585479
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271721600000",
"number": "1497892277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "222 TONGASS DR",
"city": "SITKA",
"state": "AK",
"postal_code": "998359416",
"telephone_number": "907-966-2411",
"fax_number": "907-966-8606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 TONGASS DR",
"city": "SITKA",
"state": "AK",
"postal_code": "998359416",
"telephone_number": "907-966-2411",
"fax_number": "907-966-8606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KREISS",
"first_name": "CONNIE",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-31",
"last_updated": "2010-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AK",
"license": "2284",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MD2284",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sitka, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.