NPIMap

Organization Active NPI

Independence Healthcare PC

Doing business as Corvus Neurology

  • Sleep Disorder Diagnostic Clinic/Center
  • Soldotna, AK
National Provider Identifier
1649861576
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Disorder Diagnostic Clinic/CenterTaxonomy code 261QS1200X
Legal business name
INDEPENDENCE HEALTHCARE PC
Doing business as
Corvus Neurology
Practice address
289 N Fireweed St Ste B
Soldotna, AK 99669-7570
Phone
(907) 262-6454
NPI assigned
Feb 2, 2021
Last updated
Feb 2, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
INDEPENDENCE HEALTHCARE PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

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

Authorized official

Name
Henry G KrullNPI 1669477790
Title
MD
Phone
(907) 262-6454

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Disorder Diagnostic Clinic/Center 261QS1200X Primary

Addresses

Primary practice location

289 N Fireweed St Ste B
Soldotna, AK 99669-7570

Mailing address

291 N Fireweed St
Soldotna, AK 99669-7540

Other names 1

  • Corvus Neurology Doing business as

National Provider Directory

National Provider Directory
Part of
Independence Healthcare PC

Locations

100 Trading Bay Rd
Ste 6
Kenai, AK 99611
Phone (907) 262-2596

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1612224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612224000000",
    "number": "1649861576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 N FIREWEED ST",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 N FIREWEED ST STE B",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697570",
            "telephone_number": "907-262-6454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENCE HEALTHCARE PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INDEPENDENCE HEALTHCARE PC",
        "enumeration_date": "2021-02-02",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A",
        "authorized_official_last_name": "KRULL",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "907-262-6454"
    },
    "taxonomies": [
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corvus Neurology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Soldotna, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; 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.