Active NPI
Peacehealth
Doing business as Ketchikan Medical Center
- Medicare Defined Swing Bed Hospital Unit
- Ketchikan, AK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medicare Defined Swing Bed Hospital Unit
- Legal business name
- PEACEHEALTH
- Doing business as
- Ketchikan Medical Center
- Practice address
- 3100 Tongass Ave
Ketchikan, AK 99901-5746 - Phone
- (907) 225-5171
- NPI assigned
- Jul 19, 2018
- Last updated
- Apr 16, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Arthur Craig Springer II
- Title
- Sys VP Fin Integrity/Controller
- Phone
- (360) 729-1132
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medicare Defined Swing Bed Hospital Unit | 275N00000X | NU | Primary |
Addresses
Primary practice location
3100 Tongass Ave
Ketchikan, AK 99901-5746
Mailing address
1115 SE 164TH Ave
Vancouver, WA 98683-9324
Phone (360) 729-1000
Other names 1
- Ketchikan Medical Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AK
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20181010002444 | AK | Part A Provider - Critical Access Hospital | 9436067618 |
Receives reassigned benefits from 1 practitioner Practice locations: Ketchikan, AK |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1528544822. Details of each certification follow.
Hospital certification: CCN 02Z311
- Legal name
- PEACEHEALTH
- Doing business as
- KETCHIKAN MEDICAL CENTER
- Organization structure
- Corporation
- Incorporated
- Jun 15, 1976 in AK
- Enrollment address
- 3100 Tongass Ave
Ketchikan, AK 99901-5746
Related certifications (CCN) 1
Facilities connected through Provider of Services related, parent or unit certification numbers.
-
dba Ketchikan Medical Center
- Critical Access Hospital
- Ketchikan, AK
- NPI 1396705539
Unit of hospital
Other NPIs with the same Medicare PAC ID 4
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Ketchikan Medical Center
- Critical Access Hospital
- Ketchikan, AK
- NPI 1396705539
9436067618
-
dba Ketchikan Medical Center Home Health
- Home Health Agency
- Ketchikan, AK
- NPI 1760427082
9436067618
-
dba Ketchikan Medical Center
- Diagnostic Radiology Physician
- Ketchikan, AK
- NPI 1801965736
9436067618
-
dba Ketchikan Gen Hosp LTC
- Skilled Nursing Facility
- Ketchikan, AK
- NPI 1851336176
9436067618
National Provider Directory
National Provider Directory- Tax ID family
- Ketchikan General Hsptl
Other organizations with this tax ID 4
Organizations that report the same tax identification number in the National Provider Directory.
-
- Surgery Physician
- Ketchikan, AK
- NPI 1235556846
-
- Rural Health Clinic/Center
- Craig, AK
- NPI 1528506961
-
dba Ketchikan Medical Center Home Health
- Home Health Agency
- Ketchikan, AK
- NPI 1760427082
Locations
3100 Tongass Ave
Ketchikan, AK 99901
Phone (907) 225-4104
Ownership & related parties
All disclosed owners & managing parties 19
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Kevin G Murphy | Corporate Director | Jul 1, 2016 | |
| Charlotte Virgia Davenport | Corporate Director | Jul 1, 2016 | |
| Ione S Adams | Corporate Director | Jul 1, 2024 | |
| Leonard W Kearney | Corporate Director | Jan 1, 2011 | |
| Thomas Karnes | Corporate Officer | Jan 27, 2023 | |
| Lorraine Arvin | Corporate Director | Jul 1, 2024 | |
| Danny W Hollingshead | Corporate Director | Jun 1, 2017 | |
| Richard Harry Wollenberg | Corporate Director | Jan 21, 2014 | |
| Timothy Ackman | Corporate Director | Jul 1, 2017 | |
| Arthur Craig Springer II | Corporate Officer | Nov 3, 2025 | |
| Linda Lea Jackson | W-2 Managing Employee | Jul 15, 2023 | |
| Richard E Magnuson | Corporate Officer | Jun 16, 2025 | |
| Deleesa Meashintubby | Corporate Director | Jun 30, 2023 | |
| Mary McWilliams | Corporate Director | Sep 24, 2021 | |
| Kathleen Lee Pruitt | Corporate Director | Jul 1, 2015 | |
| Sarah Marie Ness | Corporate Officer | Jan 3, 2026 | |
| Andrea C Nenzel | Corporate Director | Jul 1, 2015 | |
| Peacehealth | 5% Or Greater Direct Ownership Interest | Nov 9, 2007 | 100% |
| Donna King | Corporate Director | Jul 1, 2019 |
Owners & managing parties with NPI records 4
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
dba Ketchikan Medical Center
- Critical Access Hospital
- Ketchikan, AK
- NPI 1396705539
5% Or Greater Direct Ownership Interest
-
dba Ketchikan Medical Center Home Health
- Home Health Agency
- Ketchikan, AK
- NPI 1760427082
5% Or Greater Direct Ownership Interest
-
dba Ketchikan Medical Center
- Diagnostic Radiology Physician
- Ketchikan, AK
- NPI 1801965736
5% Or Greater Direct Ownership Interest
-
dba Ketchikan Gen Hosp LTC
- Skilled Nursing Facility
- Ketchikan, AK
- NPI 1851336176
5% Or Greater Direct Ownership Interest
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Ketchikan Medical Center - LTC | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jun 15, 1976 Jun 15, 1976 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
dba Ketchikan Gen Hosp LTC
- Skilled Nursing Facility
- Ketchikan, AK
- NPI 1851336176
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
Facilities with the same owner 1
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Ketchikan Gen Hosp LTC
- Skilled Nursing Facility
- Ketchikan, AK
- NPI 1851336176
Peacehealth
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.
-
- Emergency Medicine Physician
- Ketchikan, AK
- NPI 1891746541
Affiliated clinicians 5
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531958400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1776297600000",
"number": "1528544822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1115 SE 164TH AVE",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986839324",
"telephone_number": "360-729-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 TONGASS AVE",
"city": "KETCHIKAN",
"state": "AK",
"postal_code": "999015746",
"telephone_number": "907-225-5171"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PEACEHEALTH",
"organizational_subpart": "NO",
"enumeration_date": "2018-07-19",
"last_updated": "2026-04-16",
"certification_date": "2026-04-16",
"status": "A",
"authorized_official_last_name": "SPRINGER",
"authorized_official_first_name": "ARTHUR",
"authorized_official_middle_name": "CRAIG",
"authorized_official_title_or_position": "SYS VP FIN INTEGRITY/CONTROLLER",
"authorized_official_telephone_number": "360-729-1132",
"authorized_official_name_suffix": "II"
},
"taxonomies": [
{
"code": "275N00000X",
"taxonomy_group": "",
"desc": "Medicare Defined Swing Bed Unit",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Ketchikan Medical Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Ketchikan, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.