Alaska Island Community Services

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

Legal business name

ALASKA ISLAND COMMUNITY SERVICES

Practice address

320 Bennett St
Point Baker Community Building
PT Baker, AK 99927

Phone

(907) 874-4700

Fax

(907) 874-4719

NPI assigned

Jan 31, 2007

Last updated

Jul 10, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mark T Walker, MSW

Title

Executive Director

Phone

(907) 874-4700

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184025600000",
    "number": "1578600490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1231",
            "city": "WRANGELL",
            "state": "AK",
            "postal_code": "999291231",
            "telephone_number": "907-874-4700",
            "fax_number": "907-874-4719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 BENNETT ST",
            "address_2": "POINT BAKER COMMUNITY BUILDING",
            "city": "PT BAKER",
            "state": "AK",
            "postal_code": "99927",
            "telephone_number": "907-874-4700",
            "fax_number": "907-874-4719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALASKA ISLAND COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-07-10",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "907-874-4700",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RH544FQ",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; 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.