Kenai Medical Center Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

7331 Issued in AK

Legal business name

KENAI MEDICAL CENTER INC.

Practice address

805 Frontage Rd
Ste 123
Kenai, AK 99611-7755

Phone

(907) 283-4611

Fax

(907) 283-3992

NPI assigned

Apr 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Peter O. Hansen, M. D.

Title

President

Phone

(907) 283-4611

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528181369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 FRONTAGE RD",
            "address_2": "STE 123",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996117755",
            "telephone_number": "907-283-4611",
            "fax_number": "907-283-3992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 FRONTAGE RD",
            "address_2": "STE 123",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996117755",
            "telephone_number": "907-283-4611",
            "fax_number": "907-283-3992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENAI MEDICAL CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "907-283-4611",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "7331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MDG733",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Kenai Peninsula Community Care Center
• Kenai Peninsula Community Care Emergency
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• Kenai Peninsula Imaging Center LLC
• Kenai Senior Living LLC

• 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 Aug 22, 2020; 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.