KATMAI ONCOLOGY GROUP, LLC
NPI 1063150043
Internal Medicine - Hematology & Oncology in Eagle River, AK

Q: What is Katmai Oncology Group, LLC's NPI number?

The NPI number for Katmai Oncology Group, LLC is 1063150043. It was assigned to this organization in the NPPES registry on May 20, 2022. The provider is doing business as Eagle River.

Q: What is Katmai Oncology Group, LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Active since May 20, 2022CLIA Certified · 2 labs

12001 BUSINESS BLVD STE 3C, EAGLE RIVER, AK 99577(907) 562-0321(907) 562-2683 Get Directions Write a Review

NPPES record last updated: December 24, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 24, 2025, May 20, 2022 (2 updates tracked since 2022).

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About Katmai Oncology Group, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATMAI ONCOLOGY GROUP, LLC (NPI 1063150043), doing business as Eagle River, is a healthcare organization registered as a hematology & oncology in Eagle River, Alaska and active in the NPI registry since May 2022. The organization holds 2 active CLIA laboratory certificates and lists Shannon Smiley, Partner, as its authorized official.

NPPES Registry Identity

NPI1063150043

Entity TypeOrganization

Primary Taxonomy207RH0003X

Legal Business NameKATMAI ONCOLOGY GROUP, LLC

Location Address12001 BUSINESS BLVD STE 3CEagle River, AK 99577-7743

Mailing AddressPo Box 74900Chicago, IL 60675-4900 · (602) 441-9520 · Fax (602) 441-9524

Phone(907) 562-0321

Fax(907) 562-2683

Organization SubpartYes

Authorized OfficialShannon SmileyPartner · (907) 562-0321

Enumeration DateMay 20, 2022

Last NPPES UpdateDecember 24, 20252 updates tracked since enumeration

NPPES CertifiedDecember 24, 2025

✔ NPI 1063150043 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians

Taxonomy Code207RH0003X

Definition

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

12001 BUSINESS BLVD STE 3C, Eagle River, AK 99577

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Other Names 1

Doing Business AsEagle River

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 02D2280002

Katmai Oncology Group, LLC · Eagle River, AK

Active · expires Aug 29, 2027

CLIA Number02D2280002

Laboratory TypePhysician Office

Certificate Effective DateAugust 30, 2025

Certificate Expiration DateAugust 29, 2027

Laboratory DirectorMariah A. Jackson

Laboratory Phone(907) 562-0321

Laboratory LocationKatmai Oncology Group, LLC12001 Business Blvd Ste 3C, Eagle River, AK 99577

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 02D0869756

Katmai Oncology Group · Anchorage, AK

Active · expires Jan 18, 2028

CLIA Number02D0869756

Laboratory TypePhysician Office

Certificate Effective DateJanuary 19, 2026

Certificate Expiration DateJanuary 18, 2028

Laboratory DirectorMariah A. Jackson

Laboratory Phone(907) 562-0321

Laboratory LocationKatmai Oncology Group3851 Piper Street, Suite U340, Anchorage, AK 99508

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Katmai Oncology Group, LLC's NPI number?

The NPI number for Katmai Oncology Group, LLC is 1063150043. It was assigned to this organization in the NPPES registry on May 20, 2022. The provider is doing business as Eagle River.

Where is Katmai Oncology Group, LLC located?

Katmai Oncology Group, LLC is located at 12001 Business Blvd Ste 3C, Eagle River, AK 99577. The listed phone number is (907) 562-0321.

What is Katmai Oncology Group, LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Does Katmai Oncology Group, LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Katmai Oncology Group, LLC was last updated on December 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.