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CREEKSIDE FAMILY HEALTH CLINIC INC
NPI 1477847184
Nurse Practitioner - Family in Ketchikan, AK

Active since May 31, 2011CLIA 02D1088324 · Waiver
320 BAWDEN ST, SUITE #313, KETCHIKAN, AK 99901(907) 220-9982(907) 220-9972 Get Directions Write a Review

NPPES record last updated: November 13, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Creekside Family Health Clinic Inc NPPES

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

CREEKSIDE FAMILY HEALTH CLINIC INC (NPI 1477847184) is a healthcare organization registered as a family in Ketchikan, Alaska and active in the NPI registry since May 2011. The organization holds a CLIA Waiver certificate valid through November 30, 2026 and lists John Hill, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1477847184
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameCREEKSIDE FAMILY HEALTH CLINIC INC
Location Address320 BAWDEN ST, SUITE #313Ketchikan, AK 99901-6573
Mailing Address3521 Lomita Blvd, Suite #103Torrance, CA 90505-5039 · (310) 534-9131 · Fax (310) 534-9132
Phone(907) 220-9982
Fax(907) 220-9972
Organization SubpartNo
Authorized OfficialJohn HillOffice Manager · (907) 220-9982
Enumeration DateMay 31, 2011
Last NPPES UpdateNovember 13, 2012
✔ NPI 1477847184 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Also ListedFamily MedicineTaxonomy 207Q00000X
320 BAWDEN ST, Ketchikan, AK 99901
Open in Google Maps ↗

Other Identifiers 3

MedicaidNP0504AK
Medicare PINK161908AK
MedicaidMPG0359AK

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., 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 of Waiver 02D1088324

Creekside Family Health Clinic, Inc · Ketchikan, AK
Active · expires Nov 30, 2026
CLIA Number02D1088324
Laboratory TypePhysician Office
Certificate Effective DateDecember 1, 2024
Certificate Expiration DateNovember 30, 2026
Laboratory DirectorShawna K. Strouth-Shaw
Laboratory Phone(907) 220-9982
Laboratory LocationCreekside Family Health Clinic, Inc1225 Tongass Ave, Ketchikan, AK 99901
CLIA data matches this NPI record on: Name Phone
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.

RANDOLPH CLARK DAVIS D.C.
Chiropractor (Rehabilitation)
320 BAWDEN ST, SUITE 306
KETCHIKAN, AK 99901
Ketchikan Gateway Borough (907) 225-6815
ROTARY HOUSE OF KETCHIKAN INC
Voluntary or Charitable
320 BAWDEN ST
KETCHIKAN, AK 99901
Ketchikan Gateway Borough (907) 225-5131
LORRAINE LEILANI HILL FNP
Nurse Practitioner (Family)
320 BAWDEN ST, SUITE 313
KETCHIKAN, AK 99901
Ketchikan Gateway Borough (907) 220-9982

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 Creekside Family Health Clinic Inc's NPI number?

The NPI number for Creekside Family Health Clinic Inc is 1477847184. It was assigned to this organization in the NPPES registry on May 31, 2011.

Where is Creekside Family Health Clinic Inc located?

Creekside Family Health Clinic Inc is located at 320 Bawden St Suite #313, Ketchikan, AK 99901. The listed phone number is (907) 220-9982.

What is Creekside Family Health Clinic Inc's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Does Creekside Family Health Clinic Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 02D1088324) is associated with this NPI, valid through November 30, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Creekside Family Health Clinic Inc accept?

Health plans from Moda Health Plan, Inc. and Premera Blue Cross Blue Shield of Alaska list Creekside Family Health 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 Creekside Family Health Clinic Inc was last updated on November 13, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.