NPIMap

Organization Active NPI

Anchorage Community Mental Health Services, Inc

Doing business as Alaska Behavioral Health

  • Adolescent and Children Mental Health Clinic/Center
  • Anchorage, AK
National Provider Identifier
1255938239
Registry record updated Oct 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
ANCHORAGE COMMUNITY MENTAL HEALTH SERVICES, INC
Doing business as
Alaska Behavioral Health
Practice address
4045 Lake Otis Pkwy Ste 101
Anchorage, AK 99508-5227
Phone
(907) 563-1000
NPI assigned
Oct 3, 2020
Last updated
Oct 3, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2020

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary

Addresses

Primary practice location

4045 Lake Otis Pkwy Ste 101
Anchorage, AK 99508-5227

Mailing address

4020 Folker St Ste 209
Anchorage, AK 99508-5321

Other identifiers 1

IdentifierTypeStateIssuer
1020766MedicaidAK

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

Locations

4020 Folker St
Ste 209
Anchorage, AK 99508

351 W Parks Hwy
Ste 200
Wasilla, AK 99654

Practitioners & affiliated clinicians

Practitioners 11

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": "1601683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601683200000",
    "number": "1255938239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 FOLKER ST STE 209",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 LAKE OTIS PKWY STE 101",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085227",
            "telephone_number": "907-563-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANCHORAGE COMMUNITY MENTAL HEALTH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-03",
        "last_updated": "2020-10-03",
        "certification_date": "2020-10-03",
        "status": "A",
        "authorized_official_last_name": "EVENSON",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "907-261-5317"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1020766",
            "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 Oct 3, 2020; 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.