NPIMap

Organization Active NPI

State of Alaska Public Health Nursing

  • Community/Behavioral Health Agency
  • Ketchikan, AK
National Provider Identifier
1346601457
Registry record updated Mar 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
NURR8365 Issued in AK
Legal business name
STATE OF ALASKA PUBLIC HEALTH NURSING
Practice address
3054 Fifth Ave
Ketchikan, AK 99901-5773
Phone
(907) 225-4350
Fax
(907) 247-0978
NPI assigned
Mar 16, 2016
Last updated
Mar 16, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
STATE OF ALASKAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 16, 2016

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

Authorized official

Name
Mrs. Susan Renee Bergmann, RN
Title
Nurse Manager
Phone
(907) 225-4350

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NURR8365 AK Primary

Addresses

Primary practice location

3054 Fifth Ave
Ketchikan, AK 99901-5773

Mailing address

14818 N Tongass Hwy
Ketchikan, AK 99901-8902
Phone (907) 225-4328

Other names 1

  • State of Alaska Other name

National Provider Directory

National Provider Directory
Tax ID family
Wasilla Public Health N19 organizations share this tax ID, including this one
Part of
Wasilla Public Health N

Other organizations with this tax ID 18

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

View all 18

Practitioners & affiliated clinicians

Practitioners 9

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": "1458086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458086400000",
    "number": "1346601457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14818 N TONGASS HWY",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999018902",
            "telephone_number": "907-225-4328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3054 FIFTH AVE",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999015773",
            "telephone_number": "907-225-4350",
            "fax_number": "907-247-0978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF ALASKA PUBLIC HEALTH NURSING",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE OF ALASKA",
        "enumeration_date": "2016-03-16",
        "last_updated": "2016-03-16",
        "status": "A",
        "authorized_official_last_name": "BERGMANN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "NURSE MANAGER",
        "authorized_official_telephone_number": "907-225-4350",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AK",
            "license": "NURR8365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "State of Alaska",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ketchikan, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2016; 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.