CREEKSIDE FAMILY HEALTH CLINIC INC
NPI 1477847184
Nurse Practitioner - Family in Ketchikan, AK
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
Specialties & Licenses 2
Other Identifiers 3
Group Practice 1
Accepted 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)
Creekside Family Health Clinic Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Creekside Family Health Clinic Inc, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 of Waiver 02D1088324
Creekside Family Health Clinic, Inc · Ketchikan, AKFrequently 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.
Is Creekside Family Health Clinic Inc enrolled in Medicare?
Yes. Creekside Family Health Clinic Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Creekside Family Health Clinic Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Creekside Family Health Clinic Inc. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
# Creekside Family Health Clinic Inc · NPI 1477847184
Family organization in Ketchikan, Alaska. Organization record, active in the CMS NPPES registry since May 31, 2011.
## Identity
- **NPI:** 1477847184 (Entity type: Organization)
- **Enumerated:** May 31, 2011
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** John Hill, OFFICE MANAGER
## Practice location
- **Address:** 320 BAWDEN ST, SUITE #313, Ketchikan, AK 99901-6573
- **Phone:** (907) 220-9982 · **Fax:** (907) 220-9972
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 13, 2012
- **Other identifiers:** Medicaid NP0504 (AK); Medicare PIN K161908 (AK); Medicaid MPG0359 (AK)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1477847184) · Data from the CMS NPPES public registry.