REDOUBT MEDICAL GROUP LLC.
NPI 1386391696
Clinic/Center in Kenai, AK

Q: What is Redoubt Medical Group LLC.'s NPI number?

The NPI number for Redoubt Medical Group LLC. is 1386391696. It was assigned to this organization in the NPPES registry on March 7, 2022. The provider was formerly known as Redoubt Medical Clinic.

Q: What is Redoubt Medical Group LLC.'s specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Active since March 07, 2022CLIA 02D2180854 · Microscopy

416 FRONTAGE RD STE 200, KENAI, AK 99611(907) 283-6030(907) 283-3194 Get Directions Write a Review

NPPES record last updated: March 8, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Redoubt Medical Group Llc. NPPES

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

REDOUBT MEDICAL GROUP LLC. (NPI 1386391696), doing business as Redoubt Medical Clinic, is a healthcare organization registered as a clinic/center in Kenai, Alaska and active in the NPI registry since March 2022. The organization holds a CLIA Microscopy certificate valid through March 20, 2028 and lists Joan Itano Merrick, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1386391696

Entity TypeOrganization

Primary Taxonomy261Q00000X

Legal Business NameREDOUBT MEDICAL GROUP LLC.

Location Address416 FRONTAGE RD STE 200Kenai, AK 99611-7770

Mailing Address416 Frontage Rd Ste 200Kenai, AK 99611-7770 · (907) 283-6030 · Fax (907) 283-3194

Phone(907) 283-6030

Fax(907) 283-3194

Organization SubpartNo

Authorized OfficialJoan Itano MerrickOffice Manager · (907) 283-6030

Enumeration DateMarch 7, 2022

Last NPPES UpdateMarch 8, 2022

NPPES CertifiedMarch 8, 2022

✔ NPI 1386391696 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities

Taxonomy Code261Q00000X

Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

416 FRONTAGE RD STE 200, Kenai, AK 99611

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Other Names 1

Former Legal Business NameRedoubt Medical Clinic

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Redoubt Medical Group Llc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 2 clinicians reassign Medicare billing to Redoubt Medical Group LLC., which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Joan Itano Merrick, ANP

Nurse Practitioner

NPI 1912075482

11472 KENAI SPUR HWY STE 2
Kenai, AK 99611

(907) 283-6030

✔ PECOS✔ Accepts Medicare0.6 mi

Renae Blanton, A.N.P.

Nurse Practitioner

NPI 1639107824

4047 BARTLETT ST
Homer, AK 99603

(907) 206-2730

✔ PECOS✔ Accepts Medicare64 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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) 02D2180854

Redoubt Medical Group, LLC · Kenai, AK

Active · expires Mar 20, 2028

CLIA Number02D2180854

Laboratory TypePhysician Office

Certificate Effective DateMarch 21, 2026

Certificate Expiration DateMarch 20, 2028

Laboratory DirectorJoan Merrick

Laboratory Phone(907) 283-6030

Laboratory LocationRedoubt Medical Group, LLC130 S Willow St, Ste 1, Kenai, AK 99611

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 Redoubt Medical Group LLC.'s NPI number?

The NPI number for Redoubt Medical Group LLC. is 1386391696. It was assigned to this organization in the NPPES registry on March 7, 2022. The provider was formerly known as Redoubt Medical Clinic.

Where is Redoubt Medical Group LLC. located?

Redoubt Medical Group LLC. is located at 416 Frontage Rd Ste 200, Kenai, AK 99611. The listed phone number is (907) 283-6030.

What is Redoubt Medical Group LLC.'s specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Is Redoubt Medical Group LLC. enrolled in Medicare?

Yes. Redoubt Medical Group LLC. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Redoubt Medical Group LLC.?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Redoubt Medical Group LLC.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Redoubt Medical Group LLC. hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 02D2180854) is associated with this NPI, valid through March 20, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Redoubt Medical Group LLC. accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list Redoubt Medical Group LLC. 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 Redoubt Medical Group LLC. was last updated on March 8, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.