Active NPI
Kodiak Area Native Association
- Community Health Clinic/Center
- Kodiak, AK
National Provider Identifier
1679514236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Clinic/Center
- Legal business name
- KODIAK AREA NATIVE ASSOCIATION
- Practice address
- 3449 E Rezanof Dr
Kodiak, AK 99615-6952 - Phone
- (907) 486-9800
- Fax
- (907) 486-9898
- NPI assigned
- Jun 8, 2006
- Last updated
- Feb 28, 2024
- 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
- Mr. Mike Pfeffer II, CEO
- Title
- Ceo
- Phone
- (907) 486-9800
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Clinic/Center | 261QC1500X | Primary |
Addresses
Primary practice location
3449 E Rezanof Dr
Kodiak, AK 99615-6952
Mailing address
3449 E Rezanof Dr
Kodiak, AK 99615-6952
Phone (907) 486-9800
Other practice location 1
2414 Mill Ray Rd
Kodiak, AK 99615
Phone (907) 486-9800
Other practice location 2
3400 E Rezanof Dr
Kodiak, AK 99615-6953
Phone (907) 486-9800
Other practice location 3
1247 Mill Bay Rd # Unitsbc
Kodiak, AK 99615-6486
Phone (907) 486-9800
Other practice location 4
194 Alimaq Dr
Kodiak, AK 99615-6714
Phone (907) 486-9800
Other practice location 5
323 Carolyn St
Kodiak, AK 99615-6376
Phone (907) 486-9800
Other names 1
- KANA
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
1247 Mill Bay Rd
Ste B
Kodiak, AK 99615
1247 Mill Bay Rd
Unit Bc
Kodiak, AK 99615
Phone (907) 486-9800
323 Carolyn St
Kodiak, AK 99615
Phone (907) 486-7380
Interoperability endpoints
- colleens@direct.eatribes.net
- dkfullerswitzer@direct.kodiakhealthcare.org
- dsdeublein@direct.kodiakhealthcare.org
- ejones@direct.kodiakhealthcare.org
- empletnikoff@direct.kodiakhealthcare.org
- kgray@direct.kodiakhealthcare.org
- kmillstein@direct.kodiakhealthcare.org
- mamarkeycrimp@direct.kodiakhealthcare.org
- njengland@direct.kodiakhealthcare.org
- nkesling@direct.kodiakhealthcare.org
- pbuer@direct.kodiakhealthcare.org
- rmguevara@direct.kodiakhealthcare.org
- rponders@direct.kodiakhealthcare.org
- schelmo@direct.kodiakhealthcare.org
- smcdermott@direct.kodiakhealthcare.org
Practitioners & affiliated clinicians
Practitioners 68
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149724800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1709078400000",
"number": "1679514236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3449 E REZANOF DR",
"city": "KODIAK",
"state": "AK",
"postal_code": "996156952",
"telephone_number": "907-486-9800",
"fax_number": "907-486-9898"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3449 E REZANOF DR",
"city": "KODIAK",
"state": "AK",
"postal_code": "996156952",
"telephone_number": "907-486-9800",
"fax_number": "907-486-9898"
}
],
"practiceLocations": [
{
"address_1": "2414 Mill Ray Rd",
"address_purpose": "LOCATION",
"city": "Kodiak",
"state": "AK",
"postal_code": "99615",
"country_code": "US",
"telephone_number": "907-486-9800",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3400 E Rezanof Dr",
"address_purpose": "LOCATION",
"city": "Kodiak",
"state": "AK",
"postal_code": "996156953",
"country_code": "US",
"telephone_number": "907-486-9800",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1247 Mill Bay Rd # Unitsbc",
"address_purpose": "LOCATION",
"city": "Kodiak",
"state": "AK",
"postal_code": "996156486",
"country_code": "US",
"telephone_number": "907-486-9800",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "194 Alimaq Dr",
"address_purpose": "LOCATION",
"city": "Kodiak",
"state": "AK",
"postal_code": "996156714",
"country_code": "US",
"telephone_number": "907-486-9800",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "323 Carolyn St",
"address_purpose": "LOCATION",
"city": "Kodiak",
"state": "AK",
"postal_code": "996156376",
"country_code": "US",
"telephone_number": "907-486-9800",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "KODIAK AREA NATIVE ASSOCIATION",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-08",
"last_updated": "2024-02-28",
"certification_date": "2024-02-28",
"status": "A",
"authorized_official_last_name": "PFEFFER",
"authorized_official_first_name": "MIKE",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "907-486-9800",
"authorized_official_name_prefix": "Mr.",
"authorized_official_name_suffix": "II",
"authorized_official_credential": "CEO"
},
"taxonomies": [
{
"code": "261QC1500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Community Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "KANA",
"code": "5",
"type": "Other Name"
},
{
"organization_name": "KANA",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Kodiak, AK
- Kodiak Area Native Association
- Kodiak Area Native Association
- Kodiak Area Native Association
- Kodiak Area Native Association
- Kodiak Area Native Association
- Kodiak Area Native Association
- Kodiak Area Native Association Pharmacy
- Kodiak Birth and Wellness, LLC
- Kodiak Birth and Wellness, LLC
- Kodiak Board Certified Radiology, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.