Chickaloon Native Villlage

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

Legal business name

CHICKALOON NATIVE VILLLAGE

Doing business as

Chickaloon Village Traditional Council

Practice address

16166 North Glen Highway
Mile 61.5 Glen Highway
Sutton, AK 99674-1105

Phone

(907) 745-0704

Fax

(907) 745-0708

NPI assigned

Apr 8, 2011

Last updated

Apr 8, 2011By 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

Mrs. Amanda Nicole Christiansen

Title

Clinic Manager

Phone

(907) 745-0704

Specialties & licenses 1

Addresses

Other names 1

• Chickaloon Village Traditional Council Doing business as

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

{
    "created_epoch": "1302220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302220800000",
    "number": "1619267937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1105",
            "city": "CHICKALOON",
            "state": "AK",
            "postal_code": "996741105",
            "telephone_number": "907-745-0704",
            "fax_number": "907-745-0708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16166 NORTH GLEN HIGHWAY",
            "address_2": "MILE 61.5 GLEN HIGHWAY",
            "city": "SUTTON",
            "state": "AK",
            "postal_code": "996741105",
            "telephone_number": "907-745-0704",
            "fax_number": "907-745-0708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICKALOON NATIVE VILLLAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-08",
        "last_updated": "2011-04-08",
        "status": "A",
        "authorized_official_last_name": "CHRISTIANSEN",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "907-745-0704",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "AK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chickaloon Village Traditional Council",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alaska Faith & Family Services
• Alexis Althens, LMT
• Andrew Ashton, PA-C
• Jon Todd Baughman, PAC
• Sarah Ferroni, FNP
• Joanna Myers
• Rhoda Myers
• Pauline Ann Richard, L.C.S.W.
• Southcentral Foundation (Tribal- Life House Community Health Center)

• Community Health Clinic/Center in Sutton, AK
• Providers in Sutton, AK by specialty
• Community Health Clinic/Center in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.