Peninsula Instacare

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

PENINSULA INSTACARE

Practice address

34581 Kenai Spur Hwy
Suite 1
Soldotna, AK 99669

Phone

(907) 420-0575

Fax

(907) 420-0525

NPI assigned

Mar 19, 2020

Last updated

Mar 31, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shane Udelhoven, PA,CNPI 1124355359

Title

Owner

Phone

(907) 420-0575

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Shane Udelhoven, PA-C

  • Medical Physician Assistant
  • Soldotna, AK
  • NPI 1124355359
  NPD Authorized official

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

{
    "created_epoch": "1584576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585612800000",
    "number": "1720614993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34581 KENAI SPUR HWY",
            "address_2": "SUITE 1",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "99669",
            "telephone_number": "907-420-0575",
            "fax_number": "907-420-0525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34581 KENAI SPUR HWY",
            "address_2": "SUITE 1",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "99669",
            "telephone_number": "907-420-0575",
            "fax_number": "907-420-0525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA INSTACARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-19",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A",
        "authorized_official_last_name": "UDELHOVEN",
        "authorized_official_first_name": "SHANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-420-0575",
        "authorized_official_credential": "PA,C"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Charles George Perkins, MD

• Urgent Care Clinic/Center in Soldotna, AK
• Providers in Soldotna, AK by specialty
• Urgent Care Clinic/Center in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; 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.