Ketchikan Indian Community

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

1300 Issued in OH

Legal business name

KETCHIKAN INDIAN COMMUNITY

Practice address

2960 Tongass Ave
Ketchikan, AK 99901-5742

Phone

(907) 228-4917

Fax

(907) 228-4920

NPI assigned

Mar 10, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Sue Pickrell

Title

Director of Behavioral Health

Phone

(907) 228-4917

Specialties & licenses 2

Addresses

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Kic/THC Behavioral Health Department

  • Community/Behavioral Health Agency
  • Ketchikan, AK
  • NPI 1073766317
  NPPES parent name

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

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272844800000",
    "number": "1588834154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2960 TONGASS AVE",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999015742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 TONGASS AVE",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999015742",
            "telephone_number": "907-228-4917",
            "fax_number": "907-228-4920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KETCHIKAN INDIAN COMMUNITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-10",
        "last_updated": "2010-05-03",
        "status": "A",
        "authorized_official_last_name": "PICKRELL",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "DIRECTOR OF BEHAVIORAL HEALTH",
        "authorized_official_telephone_number": "907-228-4917",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OH",
            "license": "1300",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OH",
            "license": "C.0501146",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ketchikan Emergency Physicians, LLC
• Ketchikan Eye Care Center, L.L.C.
• Ketchikan Functional Medicine
• Ketchikan Gateway Borough
• Ketchikan Gateway Borough School District
• Ketchikan Indian Corporation
• Ketchikan Indian Corporation
• Ketchikan Indian Corporation
• Ketchikan Indian Corporation
• Ketchikan Physical Therapy, LLC

• Community/Behavioral Health Agency in Ketchikan, AK
• Providers in Ketchikan, AK by specialty
• Community/Behavioral Health Agency in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.

Verify at the official NPI Registry.