NPIMap

Organization Active NPI

Eastern Aleutian Tribes, Inc.

  • Community Health Clinic/Center
  • Cold Bay, AK
National Provider Identifier
1124180963
Registry record updated May 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
EASTERN ALEUTIAN TRIBES, INC.
Practice address
65 Airport Road
Cold Bay, AK 99571
Phone
(907) 532-2000
Fax
(907) 532-2001
NPI assigned
Dec 15, 2006
Last updated
May 18, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2018

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

Authorized official

Name
Mrs. Jennifer Dahle Harrison
Title
Ceo
Phone
(907) 277-1440

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X AK Primary
Community Health Worker 172V00000X AK

Addresses

Primary practice location

65 Airport Road
Cold Bay, AK 99571

Mailing address

3380 C Street
Suite 100
Anchorage, AK 99503
Phone (907) 277-1440

Other identifiers 1

IdentifierTypeStateIssuer
CL6515MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040331000995 AK Part B Supplier - Clinic/Group Practice 2860301884 Receives reassigned benefits from 19 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Adak, AK; Whittier, AK; Sand Point, AK; Nelson Lagoon, AK; False Pass, AK; Cold Bay, AK; Akutan, AK; King Cove, AK
O20180413000684 TX Part B Supplier - Clinic/Group Practice 2860301884 Receives reassigned benefits from 80 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cold Bay, AK; Sand Point, AK; Nelson Lagoon, AK; King Cove, AK; Akutan, AK; Adak, AK; False Pass, AK

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: ctjohnson@direct.eatribes.net
  • Direct secure messaging: jonathonm@direct.eatribes.net
  • Direct secure messaging: kjackman@direct.eatribes.net
  • Direct secure messaging: linneat@direct.eatribes.net
  • Direct secure messaging: maryj@direct.eatribes.net
  • Direct secure messaging: michellek@direct.eatribes.net
  • Direct secure messaging: nshirvani@direct.eatribes.net
  • Direct secure messaging: plknowski@direct.eatribes.net
  • Direct secure messaging: sarahb@direct.eatribes.net
  • Direct secure messaging: shandal@direct.eatribes.net
  • Direct secure messaging: stbeighle@direct.eatribes.net
  • Direct secure messaging: wpkilgore@direct.eatribes.net

Practitioners & affiliated clinicians

Practitioners 19

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 19

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526601600000",
    "number": "1124180963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3380 C STREET",
            "address_2": "SUITE 100",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "99503",
            "telephone_number": "907-277-1440",
            "fax_number": "907-277-1436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 AIRPORT ROAD",
            "city": "COLD BAY",
            "state": "AK",
            "postal_code": "99571",
            "telephone_number": "907-532-2000",
            "fax_number": "907-532-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN ALEUTIAN TRIBES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2018-05-18",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "DAHLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "907-277-1440",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "AK",
            "license": null,
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "AK",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CL6515",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cold Bay, AK

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.