Tok Community Clinic, Incorporated

Primary specialty

AmbulanceTaxonomy code 341600000X

License

6185 Issued in AK

Legal business name

TOK COMMUNITY CLINIC, INCORPORATED

Practice address

Mile 124 Tok Cutoff
Tok, AK 99780-0033

Phone

(907) 883-5873

Fax

(907) 883-3640

NPI assigned

May 31, 2005

Last updated

Dec 6, 2017By 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

Jack Le Roy Rutledge

Title

Agent

Phone

(907) 883-5873

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

Tax ID family

Tok Community Clinic Incorporated2 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.

• Western Area Volunteer Emergency Service, Inc.

  • Ambulance
  • Camillus, NY
  • NPI 1720018807
  NPD tax ID

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512518400000",
    "number": "1952304271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33",
            "city": "TOK",
            "state": "AK",
            "postal_code": "997800033",
            "telephone_number": "907-883-5873",
            "fax_number": "907-883-3640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MILE 124 TOK CUTOFF",
            "city": "TOK",
            "state": "AK",
            "postal_code": "997800033",
            "telephone_number": "907-883-5873",
            "fax_number": "907-883-3640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOK COMMUNITY CLINIC, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-31",
        "last_updated": "2017-12-06",
        "status": "A",
        "authorized_official_last_name": "RUTLEDGE",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "LE ROY",
        "authorized_official_title_or_position": "AGENT",
        "authorized_official_telephone_number": "907-883-5873"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "AK",
            "license": "6185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GA6185",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Sawyer
• Lorelei Ann Stawicki, CDCS, NCACI
• Tanana Chiefs Conference
• Tok Area Mental Health Council, Inc. (Tok Area Counseling Center)
• Tok Clinic, LLC
• Sindy Lou Williams
• Joni Emma Young
• Marianne Young

• Ambulance in Tok, AK
• Providers in Tok, AK by specialty
• Ambulance in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2017; 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.