Individual provider Active NPI

Kathleen G Todd, M.D.

  • Family Medicine Physician
  • Valdez, AK
National Provider Identifier
1639188683
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1690 Issued in AK
Practice address
1001 Meals Avenue
Valdez, AK 99686-1829
Phone
(907) 835-4811
Fax
(907) 835-5162
NPI assigned
Aug 7, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1690 AK Primary

Addresses

Primary practice location

1001 Meals Avenue
Valdez, AK 99686-1829

Mailing address

PO Box 1829
Valdez, AK 99686-1829
Phone (907) 835-4811

Other identifiers 1

IdentifierTypeStateIssuer
MD16902MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040527000004 AK Practitioner - Diagnostic Radiology 8628059557 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City of ValdezGroup PAC ID 3577514694, 14 clinicians

Practice addresses (Care Compare)

911 Meals Ave
Valdez, AK 99686-0046
Phone (907) 835-2249

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1690AKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
City of Valdez Family Medicine Current Accepting new patients
City of Valdez Past Accepting new patients

Locations

1001 Meals Ave
Valdez, AK 99686
Phone (907) 835-4612

911 Meals Ave
Valdez, AK 99686
Phone (907) 835-2249

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Providence Valdez Medical CenterValdez, AK, CCN 025034 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Jun 5, 2023
Jun 5, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639188683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1829",
            "city": "VALDEZ",
            "state": "AK",
            "postal_code": "996861829",
            "telephone_number": "907-835-4811",
            "fax_number": "907-835-5162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 MEALS AVENUE",
            "city": "VALDEZ",
            "state": "AK",
            "postal_code": "996861829",
            "telephone_number": "907-835-4811",
            "fax_number": "907-835-5162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TODD",
        "first_name": "KATHLEEN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "1690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD16902",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdez, AK

Sources for this page

Verify at the official NPI Registry.