NPIMap

Organization Active NPI

Yukon-Kuskokwim Health Corporation

  • Adolescent and Children Mental Health Clinic/Center
  • Bethel, AK
National Provider Identifier
1346585056
Registry record updated Dec 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
License
NUR R 27765 Issued in AK
Legal business name
YUKON-KUSKOKWIM HEALTH CORPORATION
Practice address
528 Cheif Eddie Hoffmen
Yukon-Kuskokwim Health Corporation
Bethel, AK 99559-0528
Phone
(907) 546-6106
Fax
(907) 543-6159
NPI assigned
Dec 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2012

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

Authorized official

Name
Shane Carllson, RN
Title
RN
Phone
(907) 543-6106

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X NUR R 27765 AK
Adolescent and Children Mental Health Clinic/Center 261QM0855X NUR R 27765 AK Primary

Addresses

Primary practice location

528 Cheif Eddie Hoffmen
Yukon-Kuskokwim Health Corporation
Bethel, AK 99559-0528

Mailing address

PO Box 528
Yukon-Kuskokwim Health Corporation
Bethel, AK 99559-0528
Phone (907) 546-6106

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1354752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354752000000",
    "number": "1346585056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 528",
            "address_2": "YUKON-KUSKOKWIM HEALTH CORPORATION",
            "city": "BETHEL",
            "state": "AK",
            "postal_code": "995590528",
            "telephone_number": "907-546-6106",
            "fax_number": "907-543-6159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "528 CHEIF EDDIE HOFFMEN",
            "address_2": "YUKON-KUSKOKWIM HEALTH CORPORATION",
            "city": "BETHEL",
            "state": "AK",
            "postal_code": "995590528",
            "telephone_number": "907-546-6106",
            "fax_number": "907-543-6159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YUKON-KUSKOKWIM HEALTH CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-06",
        "last_updated": "2012-12-06",
        "status": "A",
        "authorized_official_last_name": "CARLLSON",
        "authorized_official_first_name": "SHANE",
        "authorized_official_title_or_position": "RN",
        "authorized_official_telephone_number": "907-543-6106",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "AK",
            "license": "NUR R 27765",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "AK",
            "license": "NUR R 27765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethel, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.