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KODIAK ISLAND AMBULATORY CARE CLINIC INC.
NPI 1366596504
Clinic/Center - Urgent Care in Kodiak, AK

Active since January 23, 2007CLIA 02D0985615 · Microscopy
202 CENTER AVE, STE. 102, KODIAK, AK 99615(907) 486-6188(907) 486-6146 Get Directions Write a Review

NPPES record last updated: May 16, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kodiak Island Ambulatory Care Clinic Inc. NPPES

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

KODIAK ISLAND AMBULATORY CARE CLINIC INC. (NPI 1366596504) is a healthcare organization registered as an urgent care in Kodiak, Alaska and active in the NPI registry since January 2007. The organization holds a CLIA Microscopy certificate valid through April 23, 2027 and lists John M. Koller, President, as its authorized official.

NPPES Registry Identity

NPI1366596504
Entity TypeOrganization
Primary Taxonomy261QU0200X
Legal Business NameKODIAK ISLAND AMBULATORY CARE CLINIC INC.
Location Address202 CENTER AVE, STE. 102Kodiak, AK 99615-1126
Mailing AddressPo Box 1126Kodiak, AK 99615-1126 · (907) 486-6188 · Fax (907) 486-6146
Phone(907) 486-6188
Fax(907) 486-6146
Organization SubpartNo
Authorized OfficialJohn M. KollerPresident · (907) 486-6188
Enumeration DateJanuary 23, 2007
Last NPPES UpdateMay 16, 2011
✔ NPI 1366596504 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Urgent CareAmbulatory Health Care Facilities
Taxonomy Code261QU0200X
License✔ Licensed in AK · DL282350
202 CENTER AVE, Kodiak, AK 99615
Open in Google Maps ↗

Other Identifiers 6

OtherK162500Medicare Ptan
OtherDL282350AK · Business License Number
MedicaidMD10072AK
Other02D0985615AK · Clia Number
Other6270850001Medicare Dme
Medicare UPING35861

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska.Insurance ›

CLIA Laboratory Certificates CMS CLIA

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 for Provider-Performed Microscopy Procedures (PPMP) 02D0985615

Kodiak Island Ambulatory Care Clinic · Kodiak, AK
Active · expires Apr 23, 2027
CLIA Number02D0985615
Laboratory TypePhysician Office
Certificate Effective DateApril 24, 2025
Certificate Expiration DateApril 23, 2027
Laboratory DirectorJohn M. Koller
Laboratory Phone(907) 486-6188
Laboratory LocationKodiak Island Ambulatory Care Clinic202 Center Street Suite 102, Kodiak, AK 99615
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.

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 Kodiak Island Ambulatory Care Clinic Inc.'s NPI number?

The NPI number for Kodiak Island Ambulatory Care Clinic Inc. is 1366596504. It was assigned to this organization in the NPPES registry on January 23, 2007.

Where is Kodiak Island Ambulatory Care Clinic Inc. located?

Kodiak Island Ambulatory Care Clinic Inc. is located at 202 Center Ave Ste. 102, Kodiak, AK 99615. The listed phone number is (907) 486-6188.

What is Kodiak Island Ambulatory Care Clinic Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Urgent Care, with taxonomy code 261QU0200X.

Does Kodiak Island Ambulatory Care Clinic Inc. hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 02D0985615) is associated with this NPI, valid through April 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Kodiak Island Ambulatory Care Clinic Inc. accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list Kodiak Island Ambulatory Care Clinic Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kodiak Island Ambulatory Care Clinic Inc. was last updated on May 16, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.