NPIMap

Organization Active NPI

Southcentral Foundation Medical Center

  • Durable Medical Equipment & Medical Supplies
  • Anchorage, AK
National Provider Identifier
1659580967
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
20467 Issued in AK
Legal business name
SOUTHCENTRAL FOUNDATION MEDICAL CENTER
Practice address
4155 Tudor Centre Dr Ste 103
Attn Sherry Reedy
Anchorage, AK 99508-5912
Phone
(907) 729-3971
Fax
(907) 729-1572
NPI assigned
May 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Paul Sherry
Title
Ceo
Phone
(907) 729-1905

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 20467 AK Primary

Addresses

Primary practice location

4155 Tudor Centre Dr Ste 103
Attn Sherry Reedy
Anchorage, AK 99508-5912

Mailing address

4155 Tudor Centre Dr Ste 103
Attn Sherry Reedy
Anchorage, AK 99508-5912
Phone (907) 729-3971

Other identifiers 1

IdentifierTypeStateIssuer
MS4320MedicaidAK

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

Locations

4155 Tudor Centre Dr
Ste 103
Anchorage, AK 99508
Phone (907) 729-3971

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659580967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4155 TUDOR CENTRE DR STE 103",
            "address_2": "ATTN SHERRY REEDY",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085912",
            "telephone_number": "907-729-3971",
            "fax_number": "907-729-1572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4155 TUDOR CENTRE DR STE 103",
            "address_2": "ATTN SHERRY REEDY",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085912",
            "telephone_number": "907-729-3971",
            "fax_number": "907-729-1572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHCENTRAL FOUNDATION MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHERRY",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "907-729-1905"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AK",
            "license": "20467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MS4320",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.