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PEACEHEALTH
NPI 1235556846
Surgery in Ketchikan, AK

Active since March 20, 2014CLIA Certified · 2 labs
212 CARLANNA LAKE RD, #204, KETCHIKAN, AK 99901(907) 225-7346 Get Directions Write a Review

NPPES record last updated: March 20, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Peacehealth NPPES

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

PEACEHEALTH (NPI 1235556846) is a healthcare organization registered as a surgery in Ketchikan, Alaska and active in the NPI registry since March 2014. The organization holds 2 active CLIA laboratory certificates and lists Lori Mccoy, Provider Enrollment Specialist, as its authorized official.

NPPES Registry Identity

NPI1235556846
Entity TypeOrganization
Primary Taxonomy208600000X
Legal Business NamePEACEHEALTH
Location Address212 CARLANNA LAKE RD, #204Ketchikan, AK 99901-5642
Mailing Address1115 Se 164th Ave, Dept 358Vancouver, WA 98683-9324 · (360) 729-1411
Phone(907) 225-7346
Organization SubpartNo
Authorized OfficialLori MccoyProvider Enrollment Specialist · (360) 729-1411
Enumeration DateMarch 20, 2014
✔ NPI 1235556846 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in AK · 5790
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
212 CARLANNA LAKE RD, Ketchikan, AK 99901
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Other Identifiers 1

Medicare PINK163430AK

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 4

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 Waiver 02D1050996

Peacehealth Pediatric Clinic · Ketchikan, AK
Active · expires Feb 16, 2028
CLIA Number02D1050996
Laboratory TypePhysician Office
Certificate Effective DateFebruary 17, 2026
Certificate Expiration DateFebruary 16, 2028
Laboratory DirectorDr. Sean V. Bhagat
Laboratory Phone(907) 225-4463
Laboratory LocationPeacehealth Pediatric Clinic3100 Tongass Ave, Ketchikan, AK 99901
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 02D2026103

Peacehealth Ketchikan Medical Center · Ketchikan, AK
Active · expires Jun 22, 2027
CLIA Number02D2026103
Laboratory TypeRural Health Clinic
Certificate Effective DateJune 23, 2025
Certificate Expiration DateJune 22, 2027
Laboratory DirectorDr. Nicole A. Morin
Laboratory Phone(907) 228-7688
Laboratory LocationPeacehealth Ketchikan Medical Center3100 Tongass Ave Attn Kmob Obgyn, Ketchikan, AK 99901
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 02D2081602

Peacehealth Medical Group Urology · Ketchikan, AK
Expired · Jul 27, 2026
CLIA Number02D2081602
Laboratory TypeCommunity Clinic
Certificate Effective DateJuly 28, 2024
Certificate Expiration DateJuly 27, 2026
Laboratory DirectorDr. John Huffer
Laboratory Phone(907) 225-7346
Laboratory LocationPeacehealth Medical Group Urology3100 Tongass Ave Attention Phmg Urology, Ketchikan, AK 99901
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Waiver 02D0641458

Peacehealth Primary Care Clinic · Ketchikan, AK
Expired · Aug 5, 2026
CLIA Number02D0641458
Laboratory TypePhysician Office
Certificate Effective DateAugust 6, 2024
Certificate Expiration DateAugust 5, 2026
Laboratory DirectorPeter E. Rice
Laboratory Phone(907) 225-4104
Laboratory LocationPeacehealth Primary Care Clinic3100 Tongass Avenue, Ketchikan, AK 99901
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. LOUIS E. KLEAGER M.D.
Otolaryngology
212 CARLANNA LAKE RD, SUITE 201
KETCHIKAN, AK 99901
Ketchikan Gateway Borough (907) 228-7611
LOUIS E KLEAGER MD ENT PC
Otolaryngology
212 CARLANNA LAKE RD
KETCHIKAN, AK 99901
Ketchikan Gateway Borough (907) 228-7611
MRS. LINDA DIANE GILSON ANP
Nurse Practitioner (Adult Health)
212 CARLANNA LAKE RD, 100
KETCHIKAN, AK 99901
Ketchikan Gateway Borough (907) 228-8140

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 Peacehealth's NPI number?

The NPI number for Peacehealth is 1235556846. It was assigned to this organization in the NPPES registry on March 20, 2014.

Where is Peacehealth located?

Peacehealth is located at 212 Carlanna Lake Rd #204, Ketchikan, AK 99901. The listed phone number is (907) 225-7346.

What is Peacehealth's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Does Peacehealth 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 Peacehealth was last updated on March 20, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years 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.