Eastern Aleutian Tribes, Inc.
Organization Active NPI Community Health Clinic/Center · Cold Bay, AK
NPI 1124180963 · NPPES record last updated May 18, 2018
Key facts
- NPI
- 1124180963
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Health Clinic/Center 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
- Organization subpart
- No
Authorized official
- Name
- Mrs. Jennifer Dahle Harrison
- Title
- Ceo
- Phone
- (907) 277-1440
Other NPIs on the same Medicare enrollment 9
Practitioners 19
-
Shigone Beighle, PA
-
Olegario Carrillo, PA-C
-
Sarah Elizabeth Hood, PA-C
-
William Paul Kilgore, PA-C
-
Shanda Renee Lohse, M.D.
-
Phillip Ross Hurd, FNP
-
Chadwick T. Johnson, ACNP
-
Mary I Jones, FNP-C
-
Michelle Renee Kaplan, RPA-C
-
Peggy Knowski, NP-C
-
Robert R Martin, P.A.
-
Tiana Rose Moilanen, LCSW
-
Heather A Nattkemper, PA-C
-
Elizabeth L Rogers, PA-C
-
Nicole Shirvani, M.D,
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AK, TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
Interoperability endpoints
- ctjohnson@direct.eatribes.net
- jonathonm@direct.eatribes.net
- linneat@direct.eatribes.net
- nshirvani@direct.eatribes.net
- shandal@direct.eatribes.net
- michellek@direct.eatribes.net
- sarahb@direct.eatribes.net
- plknowski@direct.eatribes.net
- maryj@direct.eatribes.net
- kjackman@direct.eatribes.net
- stbeighle@direct.eatribes.net
- wpkilgore@direct.eatribes.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker |
172V00000X | AK | ||
| Community Health Clinic/Center | 261QC1500X | AK | Yes |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CL6515 | Medicaid | AK |
Other providers in Cold Bay, AK
All providers in Cold Bay, AK · Community Health Clinic/Center in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 18, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.