Denali Mesa Corporation

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

DENALI MESA CORPORATION

Doing business as

Frontier Therapy Services

Practice address

9109 Mendenhall Mall Rd
Ste 5K
Juneau, AK 99801-7113

Phone

(907) 209-8571

Fax

(907) 586-6736

NPI assigned

May 15, 2008

Organization subpart

Yes

Parent organization

DENALI MESA CORPORATIONAs reported in NPPES

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

Authorized official

Name

Mr. Patrick Kinnebrew

Title

Operations Manager

Phone

(907) 258-8618

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Frontier Therapy Services Doing business as

Part of

Denali Mesa Corporation

Locations

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1720255946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 E DOWLING RD",
            "address_2": "STE 26",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995181424",
            "telephone_number": "907-258-8618",
            "fax_number": "907-563-9291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9109 MENDENHALL MALL RD",
            "address_2": "STE 5K",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998017113",
            "telephone_number": "907-209-8571",
            "fax_number": "907-586-6736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENALI MESA CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENALI MESA CORPORATION",
        "enumeration_date": "2008-05-15",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "KINNEBREW",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "907-258-8618",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PT06931",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Frontier Therapy Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vincent M Dejoia
• Shawn Michele Dellinger-Garcia, RN
• Christopher J Demmert, NCBTMB
• Michaela Demmert
• Robin Jensena Demoski, RN
• Larry B Depute, P.A.-C
• Derek J Larsen (Happy Family Chiropractic)
• Marc Desjarlais, DDS
• Charles Henry Detjen, DMD
• Diagnostic Radiology Consultants, PC

• Physical Therapist in Juneau, AK
• Providers in Juneau, AK by specialty
• Physical Therapist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; 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.