NPIMap

Organization Active NPI

Alaska Aquatic Therapy Inc.

Doing business as Alaska Aquatic & Rehab Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Soldotna, AK
National Provider Identifier
1932244068
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
ALASKA AQUATIC THERAPY INC.
Practice address
35932 Kenai Spur Hwy
Soldotna, AK 99669-7103
Phone
(907) 398-0411
Fax
(866) 502-3411
NPI assigned
Feb 20, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Brittany Kay Gardner, DPTNPI 1184918732
Title
Owner
Phone
(190) 739-8041

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
Physical Therapy Clinic/Center 261QP2000X NU Primary

Addresses

Primary practice location

35932 Kenai Spur Hwy
Soldotna, AK 99669-7103

Mailing address

PO Box 3313
Soldotna, AK 99669-3313
Phone (907) 283-7946

Other identifiers 1

IdentifierTypeStateIssuer
TC4600MedicaidAK

Other names 2

  • Alaska Aquatic & Rehab Therapy, Inc. Former legal business name
  • Alaska Aquatic Therapy, Inc. Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL admin@alaskaaquatictherapy.com Other

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040920000894 AK Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 6800864604 Practice locations: Kenai, AK; Soldotna, AK
O20221212000389 AK Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6800864604 Receives reassigned benefits from 19 practitioners
Practice locations: Nikiski, AK; Soldotna, AK

National Provider Directory

National Provider Directory

Locations

9583 Kenai Spur Hwy
Nikiski, AK 99611
Phone (907) 283-7476

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": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1932244068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3313",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996693313",
            "telephone_number": "907-283-7946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35932 KENAI SPUR HWY",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697103",
            "telephone_number": "907-398-0411",
            "fax_number": "866-502-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALASKA AQUATIC THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "190-739-8041",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TC4600",
            "state": "AK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "admin@alaskaaquatictherapy.com",
            "affiliation": "N",
            "endpointDescription": "e-mail",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "info@alaskaaquatictherapy.com",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "e-mail",
            "address_1": "35932 Kenai Spur Hwy",
            "city": "Soldotna",
            "state": "AK",
            "country_code": "US",
            "postal_code": "996697103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Alaska Aquatic & Rehab Therapy, Inc.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Alaska Aquatic & Rehab Therapy, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Alaska Aquatic Therapy, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Alaska Aquatic Therapy, Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jul 21, 2022; 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.

Verify at the official NPI Registry.