NPIMap

Organization Active NPI

Palmer Senior Citizens Center, Inc.

  • Adult Day Care Clinic/Center
  • Palmer, AK
National Provider Identifier
1407907629
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
License
283892 Issued in AK
Legal business name
PALMER SENIOR CITIZENS CENTER, INC.
Practice address
1132 S Chugach St
Palmer, AK 99645-6627
Phone
(907) 623-7723
Fax
(907) 746-5173
NPI assigned
Jan 15, 2007
Last updated
Dec 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Authorized official

Name
Timothy Pettit
Title
Ceo
Phone
(907) 761-5008

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 261860 AK
Voluntary or Charitable Agency 251V00000X 261859 AK
Clinic/Center 261Q00000X 261859 AK
Adult Day Care Clinic/Center 261QA0600X 283892 AK Primary
Non-emergency Medical Transport (VAN) 343900000X 261861 AK

Addresses

Primary practice location

1132 S Chugach St
Palmer, AK 99645-6627

Mailing address

1132 S Chugach St
Palmer, AK 99645-6627
Phone (907) 623-7723

Other identifiers 3

IdentifierTypeStateIssuer
HC7853MedicaidAK
CMG503MedicaidAK
TX6161MedicaidAK

National Provider Directory

National Provider Directory

Locations

1132 S Chugach St
Palmer, AK 99645
Phone (907) 745-5454

831 S Chugach St
Palmer, AK 99645
Phone (907) 745-5454

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733961600000",
    "number": "1407907629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1132 S CHUGACH ST",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996456627",
            "telephone_number": "907-623-7723",
            "fax_number": "907-746-5173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1132 S CHUGACH ST",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996456627",
            "telephone_number": "907-623-7723",
            "fax_number": "907-746-5173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMER SENIOR CITIZENS CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-15",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A",
        "authorized_official_last_name": "PETTIT",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "907-761-5008"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "AK",
            "license": "261860",
            "primary": false
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "AK",
            "license": "261859",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "AK",
            "license": "261859",
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "AK",
            "license": "283892",
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "AK",
            "license": "261861",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HC7853",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CMG503",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TX6161",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmer, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; 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.