KATMAI ONCOLOGY GROUP, LLC
NPI 1063150043
Internal Medicine - Hematology & Oncology in Eagle River, AK
- Organization
- Internal Medicine
- Hematology & Oncology
- CLIA Number: 02D0869756
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 01-18-2028
About KATMAI ONCOLOGY GROUP, LLC
This page provides the complete NPI Profile along with additional information for Katmai Oncology Group, Llc, an internist established in Eagle River, Alaska operating as a Internal Medicine, focusing in hematology & oncology . The healthcare provider is registered in the NPI registry with number 1063150043 assigned on May 2022. The practitioner's primary taxonomy code is 207RH0003X. The provider is registered as an organization and their NPI record was last updated one year ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Shannon Smiley Md (Partner)
- NPI
- 1063150043 Verify this NPI
- Provider Name
- KATMAI ONCOLOGY GROUP, LLC
- Entity Type
- Organization
- Location Address
- 12001 BUSINESS BLVD STE 3C EAGLE RIVER, AK 99577
- Location Phone
- (907) 562-0321
- Location Fax
- (907) 562-2683
- Mailing Address
- PO BOX 74900 CHICAGO, IL 60675
- Mailing Phone
- (602) 441-9520
- Mailing Fax
- (602) 441-9524
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 05-20-2022
- Last Update Date
- 12-24-2025
- Code Navigator
An internist like Katmai Oncology Group, Llc is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
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
Internal Medicine Hematology & Oncology
- Taxonomy Code
- 207RH0003X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- 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.
Group Taxonomy 193400000X MULTIPLE SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
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
- 02D0869756
- Facility Type
- Physician Office
- Certificate Effective Date
- January 19, 2026
- Certificate Expiration Date
- January 18, 2028
- Laboratory Director
- MARIAH A. JACKSON
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Katmai Oncology Group, Llc after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1063150043, enumerated as an "organization" on May 20, 2022.
The provider is located at 12001 BUSINESS BLVD STE 3C EAGLE RIVER, AK 99577 and the phone number is (907) 562-0321.
Internal Medicine with taxonomy code 207RH0003X and a focus in Hematology & Oncology.
