NPIMap

Organization Active NPI

Southcentral Foundation

  • Rehabilitation Chiropractor
  • Wasilla, AK
National Provider Identifier
1508386178
Registry record updated Jun 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
20467 Issued in AK
Legal business name
SOUTHCENTRAL FOUNDATION
Practice address
1001 S Knik Goose Bay Rd
Wasilla, AK 99654-8083
Phone
(907) 729-8624
NPI assigned
Jun 23, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2017

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

Authorized official

Name
Ronald Lee Olson
Title
VP of Finance
Phone
(907) 729-4939

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NR0400X 20467 AK Primary

Addresses

Primary practice location

1001 S Knik Goose Bay Rd
Wasilla, AK 99654-8083

Mailing address

4501 Diplomacy Dr
Anchorage, AK 99508-5919
Phone (907) 729-4955

National Provider Directory

National Provider Directory
Tax ID family
Anchorage Primary Care Clinic103 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1498176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498176000000",
    "number": "1508386178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 DIPLOMACY DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085919",
            "telephone_number": "907-729-4955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S KNIK GOOSE BAY RD",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996548083",
            "telephone_number": "907-729-8624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHCENTRAL FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-23",
        "last_updated": "2017-06-23",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "907-729-4939"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "AK",
            "license": "20467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2017; 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.