NPIMap

Organization Active NPI

Stone Brook Inn Inc

  • Assisted Living Facility
  • Soldotna, AK
National Provider Identifier
1073635280
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
STONE BROOK INN INC
Practice address
48420 Moose Run Road
Soldotna, AK 99669
Phone
(907) 260-4498
Fax
(907) 262-1593
NPI assigned
Apr 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Audra Hedman
Title
President-Administrator
Phone
(907) 252-2679

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AK Primary

Addresses

Primary practice location

48420 Moose Run Road
Soldotna, AK 99669

Mailing address

PO Box 144
Soldotna, AK 99669-0144
Phone (907) 260-4498

Other identifiers 1

IdentifierTypeStateIssuer
RL54122MedicaidAK

Other names 1

  • Stone Brook Inn 2 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Stone Brook Inn Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073635280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 144",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996690144",
            "telephone_number": "907-260-4498",
            "fax_number": "907-262-1593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48420 MOOSE RUN ROAD",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "99669",
            "telephone_number": "907-260-4498",
            "fax_number": "907-262-1593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONE BROOK INN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HEDMAN",
        "authorized_official_first_name": "AUDRA",
        "authorized_official_title_or_position": "PRESIDENT-ADMINISTRATOR",
        "authorized_official_telephone_number": "907-252-2679"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RL54122",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stone Brook Inn 2",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Soldotna, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.