KODIAK AREA NATIVE ASSOCIATION
NPI 1205883907
Clinic/Center - Dental in Kodiak, AK
NPI Status: Active since May 28, 2006
Contact Information
3449 E REZANOF DR
KODIAK, AK
ZIP 99615
Phone: (907) 486-9800
Fax: (907) 486-9897
- Organization
- Clinic/Center
- Dental
- Accepts Insurance
- CLIA Number: 02D2136079
- CLIA Cert. Type: Federally Qualified Health Center
- CLIA Exp. Date: 08-31-2025
About KODIAK AREA NATIVE ASSOCIATION
This page provides the complete NPI Profile along with additional information for Kodiak Area Native Association, a provider established in Kodiak, Alaska operating as a Clinic/center, focusing in dental . The healthcare provider is registered in the NPI registry with number 1205883907 assigned on May 2006. The practitioner's primary taxonomy code is 261QD0000X with license number 233103 (AK). The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Mike Pfeffer (Ceo)
- NPI
- 1205883907
- Provider Name
- KODIAK AREA NATIVE ASSOCIATION
- Entity Type
- Organization
- Location Address
- 3449 E REZANOF DR KODIAK, AK 99615
- Location Phone
- (907) 486-9800
- Location Fax
- (907) 486-9897
- Mailing Address
- 3449 E REZANOF DR KODIAK, AK 99615
- Mailing Phone
- (907) 486-9800
- Mailing Fax
- (907) 486-9897
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-28-2006
- Last Update Date
- 02-15-2024
- Code Navigator
Location Map
Secondary Locations
- 2414 Mill Bay Rd
Kodiak, AK 99615
(907) 486-9800
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Dental
- Taxonomy Code
- 261QD0000X
- Type
- Ambulatory Health Care Facilities
- License No.
- 233103
- License State
- AK
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 261QC1500X | Ambulatory Health Care Facilities | Clinic/Center |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Premera Blue Cross Alaska One Gold - PPO
- Premera Blue Cross Preferred Bronze 5800 HSA - PPO
- Premera Blue Cross Preferred Bronze 6350 - PPO
- Premera Blue Cross Preferred Gold 1500 - PPO
- Premera Blue Cross Preferred Silver 4500 - PPO
- Premera Blue Cross Standard Bronze II - PPO
- Premera Blue Cross Standard Gold - PPO
- Premera Blue Cross Standard Silver - PPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1003903 | MEDICAID (05) | AK |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 02D2136079
- Facility Type
- Federally Qualified Health Center
- Certificate Effective Date
- September 01, 2023
- Certificate Expiration Date
- August 31, 2025
- Laboratory Director
- DR. EVAN JONES
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Kodiak Area Native Association in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 2 | 0 | 5 | 8 | 8 | 3 | 9 | 0 | 7 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 0 | 5 | 16 | 8 | 6 | 9 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 0 + 5 + 1 + 6 + 8 + 6 + 9 + 0 + 24 = 63 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 63 = 7 | 7 | ||||||||
The NPI number 1205883907 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1912091935 | CHARLES W PHILLIPS DD Individual | Dentist (General Practice) | 3449 E REZANOF DR KODIAK, AK 99615 (907) 486-9800 |
| 1639220288 | AMELIA LOPEZ Individual | Preventive Medicine (Public Health & General Preventive Medicine) | 3449 E REZANOF DR KODIAK, AK 99615 (907) 486-3479 |
| 1518094481 | AMANDA VIVIAN SANFORD Individual | Case Manager/Care Coordinator | 3449 E REZANOF DR KODIAK, AK 99615 (907) 486-1367 |
| 1518094416 | NANCY JEAN WELLS Individual | Case Manager/Care Coordinator | 3449 E REZANOF DR KODIAK, AK 99615 (907) 486-1366 |
| 1770617466 | DR. BRIAN M NAROG PHARM.D. Individual | Pharmacist | 3449 E REZANOF DR KODIAK, AK 99615 (907) 486-9860 |
| 1669695466 | STEVE SMITH HYGIENIST Individual | Dental Hygienist | 3449 E REZANOF DR KODIAK, AK 99615 (907) 486-9820 |
| 1063634491 | MICHAEL HANDRICKS Individual | Counselor | 3449 E REZANOF DR KODIAK, AK 99615 (907) 486-9824 |
| 1295914877 | MRS. SHANA J JONES RN Individual | General Practice | 3449 E REZANOF DR KODIAK, AK 99615 (907) 486-9800 |
| 1477732980 | NADIYA JAMES RN Individual | General Practice | 3449 E REZANOF DR KODIAK, AK 99615 (907) 486-9800 |
| 1598946923 | CHERIE COWAN DO Individual | Dental Hygienist | 3449 E REZANOF DR KODIAK, AK 99615 (907) 486-9850 |
| 1740464437 | HEATHER PARKER DO Individual | Dental Hygienist | 3449 E REZANOF DR KODIAK, AK 99615 (907) 486-9850 |
| 1467611699 | GEORGIA J BLAIN Individual | General Practice | 3449 E REZANOF DR KODIAK, AK 99615 (907) 486-9870 |
| 1215196423 | DIANE C WOLKOFF Individual | General Practice | 3449 E REZANOF DR KODIAK, AK 99615 (907) 486-9870 |
| 1669631891 | JUDITH K SPOERER Individual | General Practice | 3449 E REZANOF DR KODIAK, AK 99615 (907) 486-9870 |
| 1275792913 | MARSHA R MADRIAGA Individual | Phlebology | 3449 E REZANOF DR KODIAK, AK 99615 (907) 486-9870 |
| 1760643621 | JENNIFER R MOE Individual | General Practice | 3449 E REZANOF DR KODIAK, AK 99615 (907) 486-9870 |
| 1275863888 | MELODY DAWN LIVNGSTON MSW Individual | Social Worker (Clinical) | 3449 E REZANOF DR KODIAK, AK 99615 (907) 942-5205 |
| 1912229469 | SABRINA RENEE CHRISTIANSEN RN Individual | Registered Nurse | 3449 E REZANOF DR KODIAK, AK 99615 (907) 486-9870 |
| 1407178957 | MRS. SUE LILLIAN DEVERS RN Individual | General Practice | 3449 E REZANOF DR KODIAK, AK 99615 (907) 486-9870 |
| 1124335757 | MARGARET KAVANAUGH Individual | Case Manager/Care Coordinator | 3449 E REZANOF DR INFANT LEARNING PROGRAM KODIAK, AK 99615 (907) 486-1374 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1205883907, enumerated in the NPI registry as an "organization" on May 28, 2006
The provider is located at 3449 E Rezanof Dr Kodiak, Ak 99615 and the phone number is (907) 486-9800
This medical organization specializes in Clinic/Center with taxonomy code 261QD0000X with a focus in Dental
The provider might be accepting Accepts: Premera Blue Cross Blue Shield of Alaska, Medicare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 02D2136079 for a "federally qualified health center" facility with a CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP). This CLIA certificate is issued in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing..
This NPI record was last updated on May 28, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.