NPIMap

Organization Active NPI

Yukon Kuskokwim Health Corporation

  • Community/Behavioral Health Agency
  • Bethel, AK
National Provider Identifier
1225629249
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
YUKON KUSKOKWIM HEALTH CORPORATION
Practice address
5016 Noel Polty Drive
Bethel, AK 99559
Phone
(907) 543-6452
NPI assigned
Feb 2, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

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

Authorized official

Name
Carol Ann Willard
Title
Provider Enrollment Administrator
Phone
(907) 543-6452

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

5016 Noel Polty Drive
Bethel, AK 99559

Mailing address

PO Box 3427
Bethel, AK 99559-3427
Phone (907) 543-6452

National Provider Directory

National Provider Directory
Tax ID family
Edith Kawagley Memorial32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1612224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612224000000",
    "number": "1225629249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3427",
            "city": "BETHEL",
            "state": "AK",
            "postal_code": "995593427",
            "telephone_number": "907-543-6452",
            "fax_number": "907-543-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5016 NOEL POLTY DRIVE",
            "city": "BETHEL",
            "state": "AK",
            "postal_code": "99559",
            "telephone_number": "907-543-6452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YUKON KUSKOKWIM HEALTH CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-02",
        "last_updated": "2021-02-02",
        "certification_date": "2021-01-15",
        "status": "A",
        "authorized_official_last_name": "WILLARD",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT ADMINISTRATOR",
        "authorized_official_telephone_number": "907-543-6452"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethel, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; 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.