Providence Health & Services Washington

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

NOT NUMBERED Issued in AK

Legal business name

PROVIDENCE HEALTH & SERVICES WASHINGTON

Practice address

4001 Dale St
Suite 101
Anchorage, AK 99508-5444

Phone

(907) 212-0256

NPI assigned

Oct 28, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Donald W Anderson Jr.

Title

Dir Reimb Reg Strat/Asst Sec Enroll

Phone

(425) 525-5392

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• PROVIDENCE HOSPICE ALASKA Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Providence Health & Services Washington

  • General Acute Care Hospital
  • Anchorage, AK
  • NPI 1053363119

  Member Of

  NPD member

Locations

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• CP Ak Hospice, LLC

  • Community Based Hospice Care Agency
  • Anchorage, AK
  • NPI 1114749132

  Sold to, 2025-02-27

  CMS change of ownership

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

{
    "created_epoch": "1256688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650326400000",
    "number": "1275869117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 DALE ST STE 101",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085444",
            "telephone_number": "907-212-0256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 DALE ST",
            "address_2": "SUITE 101",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085444",
            "telephone_number": "907-212-0256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HEALTH & SERVICES WASHINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-28",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "DIR REIMB REG STRAT/ASST SEC ENROLL",
        "authorized_official_telephone_number": "425-525-5392",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "AK",
            "license": "NOT NUMBERED",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1992743561",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROVIDENCE HOSPICE ALASKA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Providence Health & Services - Washington
• Providence Health & Services Washington
• Providence Health & Services Washington
• Providence Health & Services Washington
• Providence Health & Services Washington
• Providence Health & Services Washington
• Providence Health & Services Washington
• Providence Health & Services Washington
• Providence Health & Services Washington
• Providence Health & Services Washington

• Community Based Hospice Care Agency in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Community Based Hospice Care Agency in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.