NPIMap

Organization Active NPI

Municipality of Skagway

Doing business as Dahl Memorial Clinic

  • Federally Qualified Health Center (FQHC)
  • Skagway, AK
National Provider Identifier
1063574200
Registry record updated Jul 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MUNICIPALITY OF SKAGWAY
Doing business as
Dahl Memorial Clinic
Practice address
350 14TH Avenue
Skagway, AK 99840
Phone
(907) 983-2255
Fax
(907) 983-2793
NPI assigned
Dec 14, 2006
Last updated
Jul 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2025

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

Authorized official

Name
Mr. Albert Wall
Title
Executive Director
Phone
(907) 983-2255

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X AK
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Family Nurse Practitioner 363LF0000X AK

Addresses

Primary practice location

350 14TH Avenue
Skagway, AK 99840

Mailing address

PO Box 537
Skagway, AK 99840-0537
Phone (907) 983-2255

Other identifiers 3

IdentifierTypeStateIssuer
153026OtherAKMEDICARE PART B
021836OtherAKMEDICARE FQHC
1029911MedicaidAK

Other names 1

  • Dahl Memorial Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040427001153 AK Part B Supplier - Clinic/Group Practice 0244227726 Receives reassigned benefits from 50 practitioners
Practice locations: Skagway, AK
O20071022000691 AK Part A Provider - Federally Qualified Health Center (FQHC) 0244227726 Practice locations: Skagway, AK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063574200. Details of each certification follow.

Federally qualified health center certification: CCN 021836

Legal name
MUNICIPALITY OF SKAGWAY
Doing business as
DAHL MEMORIAL CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 15, 2008
Last certification
Apr 15, 2008
Ownership / control type
Non-profit – corporation
Organization structure
GovernmentNon-profit
Incorporated
Jun 27, 2007 in AK
Enrollment address
350 14TH Ave
Skagway, AK 99840-0537

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Muhammed H Zahra MD23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Municipality of Skagway Organization, Skagway, AK 5% Or Greater Direct Ownership Interest Jul 1, 2003 100%
Estelita Fielding Individual Corporate DirectorExecutive Director Jan 1, 2019 100%
W-2 Managing Employee Oct 1, 2009

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 97

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 97

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752883200000",
    "number": "1063574200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 537",
            "city": "SKAGWAY",
            "state": "AK",
            "postal_code": "998400537",
            "telephone_number": "907-983-2255",
            "fax_number": "907-983-2793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 14TH AVENUE",
            "city": "SKAGWAY",
            "state": "AK",
            "postal_code": "99840",
            "telephone_number": "907-983-2255",
            "fax_number": "907-983-2793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUNICIPALITY OF SKAGWAY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2025-07-19",
        "certification_date": "2025-07-19",
        "status": "A",
        "authorized_official_last_name": "WALL",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "907-983-2255",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "AK",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "153026",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE FQHC",
            "identifier": "021836",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1029911",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dahl Memorial Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dahl Memorial Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Skagway, AK

Sources for this page

Verify at the official NPI Registry.