NPIMap

Organization Active NPI

Anchorage Neighborhood Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Anchorage, AK
National Provider Identifier
1669475166
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ANCHORAGE NEIGHBORHOOD HEALTH CENTER, INC.
Practice address
4951 Business Park Blvd
Anchorage, AK 99503
Phone
(907) 743-7200
NPI assigned
May 27, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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

Authorized official

Name
Vadette Fowler
Title
Chief Financial Officer
Phone
(907) 743-7321

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

4951 Business Park Blvd
Anchorage, AK 99503

Mailing address

4951 Business Park Blvd
Anchorage, AK 99503-7174
Phone (907) 743-7200

Other identifiers 1

IdentifierTypeStateIssuer
1003895MedicaidAK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031216000177 AK Part A Provider - Federally Qualified Health Center (FQHC) 0941107288 Practice locations: Anchorage, AK

Federally qualified health center certification: CCN 021808

Legal name
ANCHORAGE NEIGHBORHOOD HEALTH CENTER INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 1, 1994
Last certification
Jul 1, 1994
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Nov 18, 1974 in AK
Enrollment address
4951 Business Park Blvd
Anchorage, AK 99503-7174

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Anchorage Neighborhood Health3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

4951 Business Park Blvd
Anchorage, AK 99503
Phone (907) 743-7200

1217 E 10th Ave
Anchorage, AK 99501
Phone (907) 257-4600

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Lisa Aquino Individual Corporate OfficerCeo Dec 1, 2021
W-2 Managing Employee Dec 1, 2021
Molly O'Malley Individual Other Jan 20, 2013
Harold L Johnston Individual Other Jul 1, 2019
Vadette G Fowler Individual Corporate OfficerCfo Sep 9, 2019
W-2 Managing EmployeeCfo Sep 9, 2019
Joshua Hemsath Individual OtherBoard Member Nov 1, 2016
Michelle Nesbett Individual OtherBoard Member Jan 20, 2013
Karen Turner Individual Other Jun 20, 2013
Terri Lomax Individual Other Dec 1, 2018
Robert P Onders Individual Other Jan 1, 2019
Leroy Williams Individual OtherBoard Member May 1, 2017
Leah Van Sandt Individual Other Jan 20, 2015
Brandi Zeman Individual Other Jul 1, 2018
Cindy J Gilder Individual Other Oct 1, 2021

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 45

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650240000000",
    "number": "1669475166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4951 BUSINESS PARK BLVD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995037174",
            "telephone_number": "907-743-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4951 BUSINESS PARK BLVD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "99503",
            "telephone_number": "907-743-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANCHORAGE NEIGHBORHOOD HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-27",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "VADETTE",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "907-743-7321"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003895",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.