NPIMap

Organization Active NPI

Interior Community Health Center

  • Primary Care Clinic/Center
  • Healy, AK
National Provider Identifier
1609942754
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
INTERIOR COMMUNITY HEALTH CENTER
Practice address
Usibelli Spur Rd
Tri Valley Community Center
Healy, AK 99743
Phone
(907) 455-4567
NPI assigned
Nov 28, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Cheryl Kilgore
Title
Excutive Director
Phone
(907) 455-4567

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU
Primary Care Clinic/Center 261QP2300X NU Primary
Rural Health Clinic/Center 261QR1300X NU

Addresses

Primary practice location

Usibelli Spur Rd
Tri Valley Community Center
Healy, AK 99743

Mailing address

1606 23Rd Ave
Fairbanks, AK 99701-6407
Phone (907) 455-4567

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031105000421 AK Part B Supplier - Clinic/Group Practice 9830001031 Receives reassigned benefits from 7 practitioners
3 other NPIs on this enrollment
Practice locations: Fairbanks, AK; Healy, AK

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory

Locations

1949 Gillam Way
Ste D
Fairbanks, AK 99701

Practitioners & affiliated clinicians

Practitioners 8

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": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1609942754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1606 23RD AVE",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997016407",
            "telephone_number": "907-455-4567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "USIBELLI SPUR RD",
            "address_2": "TRI VALLEY COMMUNITY CENTER",
            "city": "HEALY",
            "state": "AK",
            "postal_code": "99743",
            "telephone_number": "907-455-4567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERIOR COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "KILGORE",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "EXCUTIVE DIRECTOR",
        "authorized_official_telephone_number": "907-455-4567"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Healy, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.