NPIMap

Organization Active NPI

Katmai Oncology Group, LLC

  • Medical Oncology Physician
  • Anchorage, AK
National Provider Identifier
1821030206
Registry record updated Dec 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
Legal business name
KATMAI ONCOLOGY GROUP, LLC
Practice address
3851 Piper Street
#U340
Anchorage, AK 99508-4627
Phone
(907) 562-0321
Fax
(907) 562-2683
NPI assigned
Jun 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2025

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

Authorized official

Name
Shannon Smiley, MDNPI 1891715942
Title
Partner
Phone
(907) 562-0321

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X
Medical Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RX0202X Primary

Addresses

Primary practice location

3851 Piper Street
#U340
Anchorage, AK 99508-4627

Mailing address

PO Box 74900
Chicago, IL 60675-4900
Phone (602) 441-9520

Other identifiers 1

IdentifierTypeStateIssuer
1020811MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040301001234 AK Part B Supplier - Clinic/Group Practice 3072400498 Receives reassigned benefits from 12 practitioners
1 other NPI on this enrollment
Practice locations: Anchorage, AK; Eagle River, AK
O20180801001204 AK DME Supplier - Physician - Medical Oncology 3072400498 Practice locations: Anchorage, AK

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
02D0869756Katmai Oncology Group3851 Piper Street, Suite U340, Anchorage, AK 99508ComplianceJan 18, 2028

National Provider Directory

National Provider Directory
Tax ID family
Katmai Oncology Group LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3851 Piper St
Ste U340
Anchorage, AK 99508
Phone (907) 562-0321

12001 Business Blvd
Eagle River, AK 99577
Phone (907) 212-3420

12001 Business Blvd
Ste 3C
Eagle River, AK 99577
Phone (907) 562-0321

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 24

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 24

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766534400000",
    "number": "1821030206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 74900",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606754900",
            "telephone_number": "602-441-9520",
            "fax_number": "907-562-2683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3851 PIPER STREET",
            "address_2": "#U340",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084627",
            "telephone_number": "907-562-0321",
            "fax_number": "907-562-2683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATMAI ONCOLOGY GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2025-12-24",
        "certification_date": "2025-12-24",
        "status": "A",
        "authorized_official_last_name": "SMILEY",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "907-562-0321",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Medical Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1020811",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.