NPIMap

Organization Active NPI

Southcentral Foundation PDN

  • General Acute Care Hospital
  • Anchorage, AK
National Provider Identifier
1083825418
Registry record updated Jan 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
20467 Issued in AK
Legal business name
SOUTHCENTRAL FOUNDATION PDN
Practice address
4155 Tudor Centre Dr Ste 103
Attn Sherry Reedy
Anchorage, AK 99508-5912
Phone
(907) 729-3971
Fax
(907) 729-1542
NPI assigned
May 25, 2007
Last updated
Jan 29, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2008

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

Authorized official

Name
Paul Sherry
Title
Ceo
Phone
(907) 729-1905

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 20467 AK Primary

Addresses

Primary practice location

4155 Tudor Centre Dr Ste 103
Attn Sherry Reedy
Anchorage, AK 99508-5912

Mailing address

4155 Tudor Centre Dr Ste 103
Attn Sherry Reedy
Anchorage, AK 99508-5912
Phone (907) 729-3971

Other identifiers 1

IdentifierTypeStateIssuer
NA6076MedicaidAK

National Provider Directory

National Provider Directory
Tax ID family
Southcentral Foundation Nikolai Health Center103 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201564800000",
    "number": "1083825418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4155 TUDOR CENTRE DR STE 103",
            "address_2": "ATTN SHERRY REEDY",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085912",
            "telephone_number": "907-729-3971",
            "fax_number": "907-729-1542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4155 TUDOR CENTRE DR STE 103",
            "address_2": "ATTN SHERRY REEDY",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085912",
            "telephone_number": "907-729-3971",
            "fax_number": "907-729-1542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHCENTRAL FOUNDATION PDN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-25",
        "last_updated": "2008-01-29",
        "status": "A",
        "authorized_official_last_name": "SHERRY",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "907-729-1905"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "AK",
            "license": "20467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NA6076",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jan 29, 2008; 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.