NPIMap

Organization Active NPI

Central Peninsula General Hospital Inc.

Doing business as Central Peninsula Hospital

  • Rural Acute Care Hospital
  • Soldotna, AK
National Provider Identifier
1528062429
Registry record updated Feb 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Acute Care HospitalTaxonomy code 282NR1301X
License
227830 Issued in AK
Legal business name
CENTRAL PENINSULA GENERAL HOSPITAL INC.
Doing business as
Central Peninsula Hospital
Practice address
250 Hospital PL
Soldotna, AK 99669-7559
Phone
(907) 714-4404
NPI assigned
Jun 8, 2005
Last updated
Feb 25, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2012

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

Authorized official

Name
Rick Davis
Title
Ceo
Phone
(907) 714-4723

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 227830 AK
Medicare Defined Swing Bed Hospital Unit 275N00000X 227830 AK
Substance Use Disorder Rehabilitation Hospital Unit 276400000X 311489 AK
Rural Acute Care Hospital 282NR1301X 227830 AK Primary

Addresses

Primary practice location

250 Hospital PL
Soldotna, AK 99669-7559

Mailing address

250 Hospital PL
Soldotna, AK 99669-7559
Phone (907) 714-4404

Other identifiers 8

IdentifierTypeStateIssuer
0004OtherAKTRICARE
155OtherAKBLUE CROSS
DA7523MedicaidAK
HS01IPMedicaidAK
HS01SBMedicaidAK
MS7723MedicaidAK
MDG830MedicaidAK
HS01OPMedicaidAK

Other names 1

  • Central Peninsula Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040310000598 AK Part B Supplier - Clinic/Group Practice 4587552575 Receives reassigned benefits from 136 practitioners
19 other NPIs on this enrollment
Practice locations: Soldotna, AK; Kenai, AK
O20050609000176 AK Part A Provider - Hospital 4587552575 18 other NPIs on this enrollment
Practice locations: Soldotna, AK; Kenai, AK
O20120306000134 AK Part A Provider - Hospital 4587552575 Practice locations: Soldotna, AK

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1528062429. Details of each certification follow.

Hospital certification: CCN 020024

Legal name
CENTRAL PENINSULA GENERAL HOSPITAL INC
Doing business as
CENTRAL PENINSULA GENERAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Aug 5, 1971
Last certification
Aug 3, 2006
Beds
49
Ownership / control type
Other
Organization structure
CorporationProprietary
Incorporated
Jan 1, 1993 in AK
Enrollment address
250 Hospital PL
Soldotna, AK 99669-7559
Hospital subgroups
Acute care

Hospital certification: CCN 02U024

Legal name
CENTRAL PENINSULA GENERAL HOSPITAL INC
Doing business as
CENTRAL PENINSULA GENERAL HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1993 in AK
Enrollment address
250 Hospital PL
Soldotna, AK 99669-7559
Hospital Swing-Bed Unit
Hospital subgroups
Swing-bed approved

Facilities connected through Provider of Services related, parent or unit certification numbers.

View all 18

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 20

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 20

Care Compare: Hospital

Medicare Care Compare
Listed as
Central Peninsula General HospitalCCN 020024 · All quality measures
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Other
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Carrie Couey Individual Corporate DirectorBoard of Directors Jan 1, 2020
Shaun Patrick Keef Individual Corporate OfficerCeo Jan 11, 2019
W-2 Managing EmployeeCeo Jan 11, 2019
Michael Reyes Individual Corporate DirectorBoard of Directors Jan 1, 2023
Paul Ostrander Individual Corporate DirectorBoard of Directors Jan 1, 2022
Karl Hertz Individual Corporate OfficerCoo Jun 16, 2025
Central Peninsula General Hospital Inc Organization, Soldotna, AK Non-profit Operational/Managerial Control Nov 26, 2007
Trena Richardson Individual Corporate DirectorBoard of Directors Jan 1, 2020
Corporate DirectorBoard Member Oct 1, 2009
Jay S Rohloff Individual Corporate DirectorBoard of Directors Jan 1, 2021
Corporate DirectorBoard of Director Jan 1, 2021
Jesse J Kincaid Individual Corporate DirectorBoard of Directors Jan 1, 2022
Shanda Rochelle Richards Individual W-2 Managing EmployeeRevenue Cycle Director Feb 8, 2021
W-2 Managing EmployeeAssociate Cfo Feb 8, 2021
Bradley T Cross Individual Corporate DirectorBoard of Directors Jan 1, 2023
Max Best Individual Corporate DirectorBoard of Directors Jan 1, 2021
Corporate DirectorBoard of Director Jan 1, 2021
Stephanie Queen Individual Corporate DirectorBoard of Directors Jan 1, 2023
Angela Hinnegan Individual Corporate OfficerCfo Aug 1, 2025
Corporate Officer Aug 1, 2025
Barb Belloumini Individual Corporate Director Jan 1, 2025
Corporate DirectorBoard of Directors Jan 1, 2025
Silverio Mattero Individual Corporate DirectorBoard of Directors Jan 1, 2022

Owners & managing parties with NPI records 6

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Heritage PlaceSoldotna, AK, CCN 025021 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Jul 1, 2006
Feb 3, 2026

Owned or controlled facilities with NPI records 19

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 19

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 159

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 159

Affiliated clinicians 387

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 387

NPI Registry JSON

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330128000000",
    "number": "1528062429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 HOSPITAL PL",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697559",
            "telephone_number": "907-714-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 HOSPITAL PL",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697559",
            "telephone_number": "907-714-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL PENINSULA GENERAL HOSPITAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-08",
        "last_updated": "2012-02-25",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "RICK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "907-714-4723"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "AK",
            "license": "227830",
            "primary": false
        },
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "AK",
            "license": "227830",
            "primary": false
        },
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": "AK",
            "license": "311489",
            "primary": false
        },
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "AK",
            "license": "227830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "0004",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "155",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DA7523",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HS01IP",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HS01SB",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MS7723",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MDG830",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HS01OP",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Peninsula Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Soldotna, AK

Sources for this page

Verify at the official NPI Registry.