Ninilchik Community Clinic | |
15765 Kingsley Road Ninilchik AK 99639-9759 | |
(907) 567-3970 | |
(907) 567-3948 |
Full Name | Ninilchik Community Clinic |
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Speciality | Clinic/Center |
Location | 15765 Kingsley Road, Ninilchik, Alaska |
Authorized Official Name and Position | Ivan Zane Encelewski (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 9075673313 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Ninilchik Community Clinic Po Box 39368 Ninilchik AK 99639-0368 Ph: (907) 567-3970 | Ninilchik Community Clinic 15765 Kingsley Road Ninilchik AK 99639-9759 Ph: (907) 567-3970 |
NPI Number | 1609093723 |
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Provider Enumeration Date | 04/19/2007 |
Last Update Date | 06/08/2011 |
Medicare PECOS PAC ID | 9638347149 |
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Medicare Enrollment ID | O20110727000248 |
Identifier | Type | State | Issuer |
---|---|---|---|
1609093723 | NPI | - | NPPES |
CL 2699 | Medicaid | AK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QC1500X | Clinic/center - Community Health | 296082 (Alaska) | Primary |
Provider Name | Renae M Blanton |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1639107824 PECOS PAC ID: 5799795464 Enrollment ID: I20060425000560 |
Provider Name | Sarah C Spencer |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1871698852 PECOS PAC ID: 0840348173 Enrollment ID: I20090424000454 |
Provider Name | Lisa Maree Zatz |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1396198388 PECOS PAC ID: 7113207762 Enrollment ID: I20161216001996 |
Provider Name | Robin Ann Holmes |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1801201678 PECOS PAC ID: 0345465589 Enrollment ID: I20170321001420 |
Provider Name | Margaret Westner |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1437518941 PECOS PAC ID: 9133428121 Enrollment ID: I20171018001733 |
Provider Name | Kristina Finkenbinder |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1497088769 PECOS PAC ID: 3971854571 Enrollment ID: I20180920002071 |
Provider Name | Tamar Gabli Marcotte |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1417185117 PECOS PAC ID: 7810146248 Enrollment ID: I20190819003295 |
Provider Name | James Vanmeter |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518116128 PECOS PAC ID: 4587696828 Enrollment ID: I20200903002056 |
Provider Name | Sharon Geraghty |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881239259 PECOS PAC ID: 0749685329 Enrollment ID: I20210819001925 |
Provider Name | Stacy Lee Beck |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457670150 PECOS PAC ID: 8628311719 Enrollment ID: I20221201001168 |
Ninilchik Community Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 15765 Kingsley Rd, Ninilchik, AK 99639 Phone: 907-567-3970 Fax: 907-567-3902 |