NPIMap

Organization Active NPI

Driftwood Construction

  • Contractor
  • Kasaan, AK
National Provider Identifier
1629440540
Registry record updated Oct 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
1002528 Issued in AK
Legal business name
DRIFTWOOD CONSTRUCTION
Doing business as
Driftwood Construction
Practice address
First and Jones Street
Kasaan, AK 99950-0340
Phone
(907) 401-1135
NPI assigned
Oct 30, 2015
Last updated
Oct 30, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2015

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

Authorized official

Name
Darl West
Title
Owner
Phone
(907) 401-1135

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ContractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 171W00000X 1002528 AK Primary

Addresses

Primary practice location

First and Jones Street
Kasaan, AK 99950-0340

Mailing address

P.O. Box Kxa
Block 2 Lot 25
Ketchikan, AK 99950-0340
Phone (907) 401-1135

Other identifiers 1

IdentifierTypeStateIssuer
1616051MedicaidAK

Other names 1

  • Driftwood Construction Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1446163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446163200000",
    "number": "1629440540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX KXA",
            "address_2": "BLOCK 2 LOT 25",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999500340",
            "telephone_number": "907-401-1135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FIRST AND JONES STREET",
            "city": "KASAAN",
            "state": "AK",
            "postal_code": "999500340",
            "telephone_number": "907-401-1135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRIFTWOOD CONSTRUCTION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-30",
        "last_updated": "2015-10-30",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "DARL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-401-1135"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Contractor",
            "state": "AK",
            "license": "1002528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1616051",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Driftwood Construction",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kasaan, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2015; 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.