Eastern Aleutian Tribes, Inc
Organization Active NPI Community Health Clinic/Center · Adak, AK
NPI 1285796094 · NPPES record last updated Apr 13, 2015
Key facts
- NPI
- 1285796094
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Health Clinic/Center 261QC1500X
- Legal business name
- EASTERN ALEUTIAN TRIBES, INC
- Practice address
- 2105 Main Street
Adak, AK 99546 - Phone
- (907) 592-8383
- Fax
- (907) 592-4287
- NPI assigned
- Dec 15, 2006
- Organization subpart
- No
Authorized official
- Name
- Ms. Jennifer Harrison
- Title
- Executive Director
- Phone
- (907) 277-1440
Other NPIs on the same Medicare enrollment 9
Other NPIs with the same Medicare PAC ID 1
Practitioners 59
-
Keils Kitchen, PA-C
-
Ruth Singleton Alvarez, PA-C
-
Carol J Borg, CNP
-
Lesley Karin De Jaray, NP-C
-
Daniel Hartman, MD
-
Melodie Isgro, MD
-
Cameron Allred Karlsen, FNP-C
-
Olivia Jean Wall Petrie, PA-C
-
Terri Lynn Douglas, MSN, RN, FNP-BC
-
Mary I Jones, FNP-C
-
Heather Sevan Atamian, PA-C
-
Rachael Ann Chapple, FNP-C, ENP-C
-
Mitchell Forbes, PA-C
-
Rachel E. Fortes, N.P.
-
Michelle Renee Kaplan, RPA-C
-
Karen Lynn Lewis, NP
-
Teresa Renee' Pirro Vial, FNP-BC
-
Olegario Carrillo, PA-C
-
Katherine Grace Van Atta, PA-C, CNM
-
Thai Gene Verzone, PA-C
-
Jeremy Loving, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AK, TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040331000995 | AK | Part B Supplier - Clinic/Group Practice | 2860301884 |
Receives reassigned benefits from 19 practitioners 9 other NPIs on this enrollment Practice locations: Adak, AK; Whittier, AK; Sand Point, AK; Nelson Lagoon, AK; False Pass, AK; Cold Bay, AK; Akutan, AK; King Cove, AK |
| O20180413000684 | TX | Part B Supplier - Clinic/Group Practice | 2860301884 |
Receives reassigned benefits from 80 practitioners 7 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Cold Bay, AK; Sand Point, AK; Nelson Lagoon, AK; King Cove, AK; Akutan, AK; Adak, AK; False Pass, AK |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Clinic/Center | 261QC1500X | AK | Yes |
Addresses
Primary practice location
2105 Main Street
Adak, AK 99546
Mailing address
3380 C St
Suite 100
Anchorage, AK 99503-3920
Phone (907) 277-1440
Other providers in Adak, AK
All providers in Adak, AK · Community Health Clinic/Center in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 13, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.