NPIMap

Organization Active NPI

Yukon Kuskokwim Health Corp

  • Optometrist
  • Bethel, AK
National Provider Identifier
1659583383
Registry record updated Mar 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
YUKON KUSKOKWIM HEALTH CORP
Practice address
829 Chief Eddie Hoffman Hwy.
Ste 340
Bethel, AK 99559
Phone
(907) 543-6000
Fax
(907) 543-6117
NPI assigned
May 4, 2007
Last updated
Mar 3, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2008

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

Authorized official

Name
Gene Peltola
Title
Ceo
Phone
(907) 543-6020

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary
Corneal and Contact Management Optometrist 152WC0802X

Addresses

Primary practice location

829 Chief Eddie Hoffman Hwy.
Ste 340
Bethel, AK 99559

Mailing address

829 Chief Eddie Hoffman Hwy.
Suite Box 528
Bethel, AK 99559-0528
Phone (907) 543-6300

Other identifiers 1

IdentifierTypeStateIssuer
CL1414MedicaidAK

National Provider Directory

National Provider Directory
Tax ID family
Yukon-Kuskokwim HLTH Corp32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

Organizations that report the same tax identification number in the National Provider Directory.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204502400000",
    "number": "1659583383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "829 CHIEF EDDIE HOFFMAN HWY.",
            "address_2": "SUITE BOX 528",
            "city": "BETHEL",
            "state": "AK",
            "postal_code": "995590528",
            "telephone_number": "907-543-6300",
            "fax_number": "907-543-6926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "829 CHIEF EDDIE HOFFMAN HWY.",
            "address_2": "STE 340",
            "city": "BETHEL",
            "state": "AK",
            "postal_code": "99559",
            "telephone_number": "907-543-6000",
            "fax_number": "907-543-6117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YUKON KUSKOKWIM HEALTH CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2008-03-03",
        "status": "A",
        "authorized_official_last_name": "PELTOLA",
        "authorized_official_first_name": "GENE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "907-543-6020"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CL1414",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethel, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2008; 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.