NPIMap

Organization Active NPI

Stone Brook Inn Inc.

Doing business as Stone Brook Inn III

  • Assisted Living Facility
  • Soldotna, AK
National Provider Identifier
1437272168
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
STONE BROOK INN INC.
Doing business as
Stone Brook Inn III
Practice address
167 Ware House Dr
Soldotna, AK 99669-7930
Phone
(907) 260-3807
Fax
(907) 262-1593
NPI assigned
Apr 9, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Audra HedmanNPI 1376784173
Title
President-Administrator
Phone
(907) 252-2679

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AK Primary

Addresses

Primary practice location

167 Ware House Dr
Soldotna, AK 99669-7930

Mailing address

PO Box 144
Soldotna, AK 99669-0144
Phone (907) 260-3807

Other identifiers 1

IdentifierTypeStateIssuer
RL54121MedicaidAK

Other names 1

  • Stone Brook Inn III Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Stone Brook Inn Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437272168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 144",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996690144",
            "telephone_number": "907-260-3807",
            "fax_number": "907-262-1593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 WARE HOUSE DR",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697930",
            "telephone_number": "907-260-3807",
            "fax_number": "907-262-1593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONE BROOK INN INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HEDMAN",
        "authorized_official_first_name": "AUDRA",
        "authorized_official_title_or_position": "PRESIDENT-ADMINISTRATOR",
        "authorized_official_telephone_number": "907-252-2679"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RL54121",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stone Brook Inn III",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Soldotna, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.