NPIMap

Organization Active NPI

Anchorage Community Mental Health Services Inc.

Doing business as Alaska Behavioral Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Anchorage, AK
National Provider Identifier
1255047635
Registry record updated Jan 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
ANCHORAGE COMMUNITY MENTAL HEALTH SERVICES INC.
Doing business as
Alaska Behavioral Health
Practice address
4120 Laurel St
Anchorage, AK 99508-5392
Phone
(907) 563-1000
NPI assigned
Jan 27, 2023
Last updated
Jan 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2023

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

Authorized official

Name
Ashley Evenson
Title
Revenue Cycle Manager
Phone
(907) 261-5317

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X Primary
Primary Care Nurse Practitioner 363LP2300X

Addresses

Primary practice location

4120 Laurel St
Anchorage, AK 99508-5392

Mailing address

4045 Lake Otis Pkwy Ste 209
Anchorage, AK 99508-5227
Phone (907) 563-1000

Other identifiers 1

IdentifierTypeStateIssuer
1020991MedicaidAK

Other names 1

  • Alaska Behavioral Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040121000942 AK Part B Supplier - Clinic/Group Practice 1052213089 Receives reassigned benefits from 44 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wasilla, AK; Fairbanks, AK; Eielson AFB, AK; Anchorage, 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
Tax ID family
Anchorage Com Mental HL31 organizations share this tax ID, including this one

Other organizations with this tax ID 30

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

View all 30

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1674777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674777600000",
    "number": "1255047635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 LAKE OTIS PKWY STE 209",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085227",
            "telephone_number": "907-563-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4120 LAUREL ST",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085392",
            "telephone_number": "907-563-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANCHORAGE COMMUNITY MENTAL HEALTH SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-27",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "status": "A",
        "authorized_official_last_name": "EVENSON",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGER",
        "authorized_official_telephone_number": "907-261-5317"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1020991",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alaska Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 27, 2023; 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.