South Central Family Practice Clinic PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

901044 Issued in AK

Legal business name

SOUTH CENTRAL FAMILY PRACTICE CLINIC PC

Practice address

161 N Binkley St
Suite 101
Soldotna, AK 99669

Phone

(907) 260-7784

Fax

(907) 260-7738

NPI assigned

Jan 16, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Gladys J Bailon, M.D.NPI 1467436071

Title

President

Phone

(907) 260-7784

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gladys Bailon, M.D.

  • Family Medicine Physician
  • Soldotna, AK
  • NPI 1467436071
  Medicare reassignment NPD Authorized official
• Pedro E Perez, M.D.

  • Family Medicine Physician
  • Soldotna, AK
  • NPI 1700827235
  Medicare reassignment NPD
• James M. Garrity, DO, MPH

  • Specialist
  • Silverdale, WA
  • NPI 1104912807

  AK

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526601600000",
    "number": "1003967753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1249",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996691249",
            "telephone_number": "907-260-7784",
            "fax_number": "907-260-7738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 N BINKLEY ST",
            "address_2": "SUITE 101",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "99669",
            "telephone_number": "907-260-7784",
            "fax_number": "907-260-7738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CENTRAL FAMILY PRACTICE CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2018-05-18",
        "status": "A",
        "authorized_official_last_name": "BAILON",
        "authorized_official_first_name": "GLADYS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "907-260-7784",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "901044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP FEDERAL WORKERS COMP",
            "identifier": "610985200",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP FEDERAL BLACK LUNG",
            "identifier": "610985200",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFIC SOURCE HEALTH",
            "identifier": "GJ520",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Soldotna Senior Living LLC
• Stephen Solinas, OCCUPATIONAL THERAPI
• Jayne Sontag, L.AC.
• Amber Souders
• Sound Imaging, LLC
• South Sound Inpatient Physicians
• George P Spady, MD
• Caitlin Riley Sparks, LMT
• David Spence
• Alice Spencer, DPT

• Family Medicine Physician in Soldotna, AK
• Providers in Soldotna, AK by specialty
• Family Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.