NPIMap

Organization Active NPI

Bristol Bay Area Health Corporation

  • Clinic/Center
  • Aleknagik North, AK
National Provider Identifier
1235291246
Registry record updated Oct 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
BRISTOL BAY AREA HEALTH CORPORATION
Practice address
73 Main Street
Aleknagik North, AK 99555
Phone
(907) 842-5201
Fax
(907) 842-9250
NPI assigned
Dec 15, 2006
Last updated
Oct 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2023

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

Authorized official

Name
Mr. Robert Clark
Title
Ceo
Phone
(907) 842-5201

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

73 Main Street
Aleknagik North, AK 99555

Mailing address

PO Box 130
Dillingham, AK 99576-0130
Phone (907) 842-5201

Other names 1

  • ALEKNAGIK NORTH Other name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031120000998 TX Part B Supplier - Clinic/Group Practice 5890699920 Receives reassigned benefits from 432 practitioners
44 other NPIs on this enrollment
Practice locations: Lebelock, AK; Manokotak, AK; Goodnews Bay, AK; Naknek, AK; New Stuyahok, AK; Perryville, AK; Pilot Point, AK; Platinum, AK…
O20190304000785 TX Part B Supplier - Mass Immunization (Roster Biller Only) 5890699920 21 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Goodnews Bay, AK; Twin Hills, AK; Togiak, AK; South Naknek, AK; Port Heiden, AK; Platinum, AK; Pilot Point, AK; Perryville, AK…

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 38

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

View all 38

National Provider Directory

National Provider Directory

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Kanakanak HospitalDillingham, AK, CCN 021309 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 14, 2011
Kanakanak HospitalDillingham, AK, CCN 02Z309 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 14, 2011

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 444

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 444

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": "1696550400000",
    "number": "1235291246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "DILLINGHAM",
            "state": "AK",
            "postal_code": "995760130",
            "telephone_number": "907-842-5201",
            "fax_number": "907-842-9250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 MAIN STREET",
            "city": "ALEKNAGIK NORTH",
            "state": "AK",
            "postal_code": "99555",
            "telephone_number": "907-842-5201",
            "fax_number": "907-842-9250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRISTOL BAY AREA HEALTH CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-05",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "907-842-5201",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ALEKNAGIK NORTH",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "ALEKNAGIK NORTH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Sources for this page

Verify at the official NPI Registry.