NPIMap

Organization Active NPI

Mt Sanford Tribal Consortium

  • Community Health Clinic/Center
  • Mentasta, AK
National Provider Identifier
1437378189
Registry record updated Mar 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
MT SANFORD TRIBAL CONSORTIUM
Practice address
Mile 7 Mentasta Road
Mentasta, AK 99780
Phone
(907) 291-2320
Fax
(907) 291-2308
NPI assigned
Apr 24, 2007
Last updated
Mar 2, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2011

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

Authorized official

Name
George Thomas Drinkwater
Title
Chap Clinic Director
Phone
(907) 822-5399

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X NU Primary

Addresses

Primary practice location

Mile 7 Mentasta Road
Mentasta, AK 99780

Mailing address

PO Box 357
Gakona, AK 99586-0357
Phone (907) 822-5399

Other identifiers 1

IdentifierTypeStateIssuer
CL3492MedicaidAK

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299024000000",
    "number": "1437378189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 357",
            "city": "GAKONA",
            "state": "AK",
            "postal_code": "995860357",
            "telephone_number": "907-822-5399",
            "fax_number": "907-822-5810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MILE 7 MENTASTA ROAD",
            "city": "MENTASTA",
            "state": "AK",
            "postal_code": "99780",
            "telephone_number": "907-291-2320",
            "fax_number": "907-291-2308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT SANFORD TRIBAL CONSORTIUM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2011-03-02",
        "status": "A",
        "authorized_official_last_name": "DRINKWATER",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "CHAP CLINIC DIRECTOR",
        "authorized_official_telephone_number": "907-822-5399"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CL3492",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentasta, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2011; 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.