NPIMap

Organization Active NPI

Family Outreach Center for Understanding Special Needs Inc

  • Social Worker
  • Eagle River, AK
National Provider Identifier
1376620179
Registry record updated Oct 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Legal business name
FAMILY OUTREACH CENTER FOR UNDERSTANDING SPECIAL NEEDS INC
Practice address
16635 Centerfield Dr Ste 103
Eagle River, AK 99577-7745
Phone
(907) 694-6002
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2021

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

Authorized official

Name
Dixi Amidon
Title
Quality Assurance
Phone
(907) 694-6002

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X Primary

Addresses

Primary practice location

16635 Centerfield Dr Ste 103
Eagle River, AK 99577-7745

Mailing address

16635 Centerfield Dr Ste 103
Eagle River, AK 99577-7745
Phone (907) 694-6002

Other names 1

  • FOCUS INC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211203000034 AK Part B Supplier - Clinic/Group Practice 2365832425 Receives reassigned benefits from 4 practitioners
Practice locations: Eagle River, AK

National Provider Directory

National Provider Directory
Tax ID family
Family Outreach Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

16635 Centerfield Dr
Ste 103
Eagle River, AK 99577
Phone (907) 694-6002

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634515200000",
    "number": "1376620179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16635 CENTERFIELD DR STE 103",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777745",
            "telephone_number": "907-694-6002",
            "fax_number": "907-694-6015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16635 CENTERFIELD DR STE 103",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777745",
            "telephone_number": "907-694-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY OUTREACH CENTER FOR UNDERSTANDING SPECIAL NEEDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A",
        "authorized_official_last_name": "AMIDON",
        "authorized_official_first_name": "DIXI",
        "authorized_official_title_or_position": "QUALITY ASSURANCE",
        "authorized_official_telephone_number": "907-694-6002"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FOCUS INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eagle River, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; 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.