NPIMap

Organization Active NPI

Providence Health & Services Washington

Doing business as Providence Extended Care

  • Skilled Nursing Facility
  • Anchorage, AK
National Provider Identifier
1396096996
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PROVIDENCE HEALTH & SERVICES WASHINGTON
Doing business as
Providence Extended Care
Practice address
3760 Piper St
Suite 1061
Anchorage, AK 99508-4683
Phone
(907) 212-0256
Fax
(907) 212-6547
NPI assigned
Sep 24, 2012
Last updated
May 15, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
PROVIDENCE HEALTH & SERVICES WASHINGTONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Authorized official

Name
Donald W Anderson Jr.
Title
Assistant Secretary of Enrollments
Phone
(425) 358-9786

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

3760 Piper St
Suite 1061
Anchorage, AK 99508-4683

Mailing address

920 Compassion Circle
Anchorage, AK 99504
Phone (907) 212-9200

Other identifiers 1

IdentifierTypeStateIssuer
1615041MedicaidAK

Other names 1

  • Providence Extended Care Doing business as

National Provider Directory

National Provider Directory
Part of
Providence Health Services - Washington

Practitioners & affiliated clinicians

Practitioners 5

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": "1348444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747267200000",
    "number": "1396096996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 COMPASSION CIRCLE",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "99504",
            "telephone_number": "907-212-9200",
            "fax_number": "907-212-9280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3760 PIPER ST",
            "address_2": "SUITE 1061",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084683",
            "telephone_number": "907-212-0256",
            "fax_number": "907-212-6547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HEALTH & SERVICES WASHINGTON",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROVIDENCE HEALTH & SERVICES WASHINGTON",
        "enumeration_date": "2012-09-24",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY OF ENROLLMENTS",
        "authorized_official_telephone_number": "425-358-9786",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1615041",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Extended Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Providence Extended Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2025; 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.