NPIMap

Organization Active NPI

Southcentral Foundation

  • Multi-Specialty Clinic/Center
  • Anchorage, AK
National Provider Identifier
1043982671
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
SOUTHCENTRAL FOUNDATION
Practice address
3000 C St Ste 102
Anchorage, AK 99503-3975
Phone
(907) 729-8558
NPI assigned
Oct 1, 2021
Organization subpart
Yes
Parent organization
SOUTHCENTRAL FOUNDATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

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

Authorized official

Name
Ronald Lee Olson
Title
Executive Vice President Finance
Phone
(907) 729-4939

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

3000 C St Ste 102
Anchorage, AK 99503-3975

Mailing address

PO Box 35198
Seattle, WA 98124-5198

Other identifiers 2

IdentifierTypeStateIssuer
1737238MedicaidAK
1727040MedicaidAK

Other names 2

  • BH 1115-Child & Family Outpatient Services (West) Doing business as
  • Tribal- Child & Family Outpatient Services(West) Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Anchorage Primary Care Clinic103 organizations share this tax ID, including this one
Part of
Anchorage Primary Care Clinic

Organizations with this tax ID in the same state 20

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 20

Locations

3000 C St
Ste 102
Anchorage, AK 99503
Phone (907) 729-8558

3000 C St
Ste 102104
Anchorage, AK 99503
Phone (907) 729-7408

3000 C St
Anchorage, AK 99503
Phone (907) 301-7411

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1633046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695081600000",
    "number": "1043982671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35198",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981245198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 C ST STE 102",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995033975",
            "telephone_number": "907-729-8558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHCENTRAL FOUNDATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHCENTRAL FOUNDATION",
        "enumeration_date": "2021-10-01",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT FINANCE",
        "authorized_official_telephone_number": "907-729-4939"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1737238",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1727040",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BH 1115-Child & Family Outpatient Services (West)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tribal- Child & Family Outpatient Services(West)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.