KENAI PENINSULA IMAGING CENTER LLC (NPI# 1780132753) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780132753 |
| Entity Type | Organization |
| Organization Name | KENAI PENINSULA IMAGING CENTER LLC |
| Practice Address |
100 Trading Bay Rd Ste 7 Kenai AK 99611 |
| Mailing Address |
100 Trading Bay Rd Ste 7 Kenai AK 99611-7786 |
| Practice Telephone | 3607717458 |
| Mailing Telephone | 9073354674 |
| Mailing Fax Number | 9073351967 |
| Enumeration Date | 2016-09-19 |
| Last Update Date | 2018-08-14 |
| Authorized Official Name | SCOTT L CARLSON (PRESIDENT) |
| Authorized Official Telephone | 9073949120 |
| Authorized Official Credential | BA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1200X |
Clinic/Center Specialization: Magnetic Resonance Imaging (MRI) |
Ambulatory Health Care Facilities |
| Street Address |
100 TRADING BAY RD STE 7 |
| City | KENAI |
| State | AK |
| Zip Code | 99611 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649803099 | Guardian Flight LLC | Ambulance | 145 Granite Point Ct, Kenai, AK 99611 | 2020-02-13 |
| 1104482967 | James Daniel Hudson | Massage Therapist | 601 Frontage Rd Suite 103, Kenai, AK 99611 | 2019-05-16 |
| 1255996351 | Shelly Lynn Niblack | Counselor | 10200, Kenai Sour Hwy, Kenai, AK 99611 | 2019-05-03 |
| 1780142042 | Odyssey Family Practice LLC | Clinic/Center | 11595 Kenai Spur Highway, Kenai, AK 99611 | 2019-03-06 |
| 1043793656 | Jerri Ann Chivers | Massage Therapist | 10815 Kenai Spur Highway, Kenai, AK 99611 | 2018-09-10 |
| 1003320060 | Christine G. Morin | Massage Therapist | 1608 Tanga Circle, Kenai, AK 99611 | 2017-11-28 |
| 1013433259 | Amanda Mckinley | Registered Nurse | 630 Barnacle Way Suite A, Kenai, AK 99611 | 2017-08-18 |
| 1376905000 | Savana Long | Licensed Practical Nurse | 1700 Cone Avenue, Kenai, AK 99611 | 2016-03-22 |
| 1477977684 | Jac Enterprises, Inc. | Assisted Living Facility | 701 North Forest Dr, Kenai, AK 99611 | 2014-02-07 |
| 1326460387 | Colleen Mcnulty | Residential Treatment Facility, Physical Disabilities | 701 North Forest St., Kenai, AK 99611 | 2014-01-10 |
| Find all providers in zip 99611 | ||||
| Taxonomy Code | 261QM1200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Magnetic Resonance Imaging (MRI) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861880908 | Valley Upright Imaging LLC | Clinic/Center | 261 E Park Ave, Unit 3, Wasilla, AK 99654-8022 | 2014-12-23 |
Please comment or provide details below to improve the information on KENAI PENINSULA IMAGING CENTER LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.