KETCHIKAN PHYSICAL THERAPY, LLC
NPI 1801437090
Clinic/Center - Health Service in Ketchikan, AK
About Ketchikan Physical Therapy, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KETCHIKAN PHYSICAL THERAPY, LLC (NPI 1801437090) is a healthcare organization registered as a health service in Ketchikan, Alaska and active in the NPI registry since September 2019. The organization lists Amanda Marie Davidshofer, Physical Therapist, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Ketchikan Physical Therapy, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by October 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Ketchikan Physical Therapy, LLC, 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.
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 Ketchikan Physical Therapy, LLC's NPI number?
The NPI number for Ketchikan Physical Therapy, LLC is 1801437090. It was assigned to this organization in the NPPES registry on September 30, 2019.
Where is Ketchikan Physical Therapy, LLC located?
Ketchikan Physical Therapy, LLC is located at 21 Jefferson Way Ste 202, Ketchikan, AK 99901. The listed phone number is (907) 617-2052.
What is Ketchikan Physical Therapy, LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Health Service, with taxonomy code 261QH0100X.
Is Ketchikan Physical Therapy, LLC enrolled in Medicare?
Yes. Ketchikan Physical Therapy, LLC is registered in the Medicare PECOS enrollment system.
When is Ketchikan Physical Therapy, LLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Alaska, Physical/Occupational Therapy Group in Private Practice) is due for revalidation by October 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Ketchikan Physical Therapy, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Physical Therapist in Private Practice) reassigns their Medicare billing to Ketchikan Physical Therapy, 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Ketchikan Physical Therapy, LLC accept?
Health plans from Premera Blue Cross Blue Shield of Alaska list Ketchikan Physical Therapy, 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 Ketchikan Physical Therapy, LLC was last updated on September 30, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# Ketchikan Physical Therapy, Llc · NPI 1801437090
Health Service organization in Ketchikan, Alaska. Organization record, active in the CMS NPPES registry since September 30, 2019.
## Identity
- **NPI:** 1801437090 (Entity type: Organization)
- **Enumerated:** September 30, 2019
- **Primary specialty:** Clinic/Center - Health Service · taxonomy 261QH0100X
- **Organization subpart:** No
- **Authorized official:** Amanda Davidshofer, PHYSICAL THERAPIST
## Practice location
- **Address:** 21 JEFFERSON WAY STE 202, Ketchikan, AK 99901-5951
- **Phone:** (907) 617-2052
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** October 31, 2026 (Non-DME Part B, Alaska, Physical/Occupational Therapy Group in Private Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Physical Therapist in Private Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 30, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1801437090) · Data from the CMS NPPES public registry.