South Peninsula Hospital, Inc.

Primary specialty

Critical Access HospitalTaxonomy code 282NC0060X

Legal business name

SOUTH PENINSULA HOSPITAL, INC.

Practice address

4300 Bartlett Street
Homer, AK 99603-7005

Phone

(907) 235-8101

Fax

(907) 235-0253

NPI assigned

Aug 29, 2005

Last updated

Jun 22, 2026By 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

Mr. Ryan Smith

Title

Chief Executive Officer

Phone

(907) 235-0241

Specialties & licenses 5

Addresses

Other identifiers 13

Medicare fee-for-service enrollment

Enrolled in AK2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1679566269. Details of each certification follow.

• CCN 025031 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 025031

Legal name

SOUTH PENINSULA HOSPITAL INC

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Oct 26, 1994

Last certification

Aug 23, 2024

Beds

28

Ownership / control type

City/County

Organization structure

CorporationNon-profit

Incorporated

Sep 18, 1961 in AK

Enrollment address

4300 Bartlett St
Homer, AK 99603-7005

Nursing home name

SOUTH PENINSULA HOSPITAL LTC

Other NPIs with the same Medicare PAC ID 2

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

• South Peninsula Hospital, Inc

  • Critical Access Hospital
  • Homer, AK
  • NPI 1093968372

  5395636930

  Same PAC ID
• South Peninsula Hospital, Inc

  • Home Health Agency
  • Homer, AK
  • NPI 1164400750

  5395636930

  Same PAC ID

Listed as

South Peninsula Hospital LTCCCN 025031 · All quality measures

Overall star rating

5 of 5

Health inspections

5 of 5

Staffing

5 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

Government - City/county

Certified

Oct 26, 1994

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

2826.0 residents per day on average

Processed by Care Compare on Aug 1, 2026.

All disclosed owners & managing parties 18

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

Owners & managing parties with NPI records 5

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

• Edson L. Knapp, M.D.

  • Diagnostic Radiology Physician
  • Homer, AK
  • NPI 1609854173

  Corporate Director

  CMS ownership
• Christopher A Landess, MD

  • Emergency Medicine Physician
  • Homer, AK
  • NPI 1538104823

  Corporate Director

  CMS ownership
• South Peninsula Hospital, Inc

  • Critical Access Hospital
  • Homer, AK
  • NPI 1093968372

  Operational/Managerial Control

  CMS ownership
• South Peninsula Hospital, Inc

  • Home Health Agency
  • Homer, AK
  • NPI 1164400750

  Operational/Managerial Control

  CMS ownership
• Joe Marie Franz Llenos, MD

  • Family Medicine Physician
  • Caldwell, ID
  • NPI 1003073560

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• South Peninsula Hospital, Inc

  • Critical Access Hospital
  • Homer, AK
  • NPI 1093968372

  Operational/Managerial Control

  CMS ownership
• South Peninsula Hospital, Inc

  • Home Health Agency
  • Homer, AK
  • NPI 1164400750

  Operational/Managerial Control

  CMS ownership

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• South Peninsula Hospital, Inc

  • Critical Access Hospital
  • Homer, AK
  • NPI 1093968372

  South Peninsula Hospital Inc

  CMS ownership
• South Peninsula Hospital, Inc

  • Home Health Agency
  • Homer, AK
  • NPI 1164400750

  South Peninsula Hospital Inc

  CMS ownership

Practitioners 169

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.

• Ahmed S Abuzaid, MD

  • Cardiovascular Disease Physician
  • Anchorage, AK
  • NPI 1437413895

  Internal Medicine

  Medicare reassignment NPD
• Brent M. Adcox, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Homer, AK
  • NPI 1437339454
  Medicare reassignment NPD
• Gregory A Aird, MD

  • Diagnostic Radiology Physician
  • Homer, AK
  • NPI 1417512005
  Medicare reassignment NPD
• Jenna L Aird, MD

  • Dermatology Physician
  • Homer, AK
  • NPI 1568027159
  Medicare reassignment NPD
• Hans Amen, D.O.

  • Family Medicine Physician
  • Homer, AK
  • NPI 1538426507
  Medicare reassignment NPD
• James David Andrews, M.D.

  • Otolaryngology Physician
  • Anchorage, AK
  • NPI 1558528745
  Medicare reassignment NPD
• Richard A Anschuetz, M.D.

  • Interventional Cardiology Physician
  • Anchorage, AK
  • NPI 1386669174
  Medicare reassignment NPD
• Jesse W Atwood, MD

  • Pediatrics Physician
  • Palmer, AK
  • NPI 1700894664
  Medicare reassignment NPD
• Krzysztof W Balaban, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Anchorage, AK
  • NPI 1528083334

  Internal Medicine

  Medicare reassignment NPD
• Louis Bartoletti, MD

  • Family Medicine Physician
  • Soldotna, AK
  • NPI 1790133239
  Medicare reassignment NPD
• William Harrison Bell, MD

  • Family Medicine Physician
  • Homer, AK
  • NPI 1992711337
  Medicare reassignment NPD
• Kira Bendixen, DO

  • Family Medicine Physician
  • Dillingham, AK
  • NPI 1821401423
  Medicare reassignment NPD

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

{
    "created_epoch": "1125273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782086400000",
    "number": "1679566269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 BARTLETT ST",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996037005",
            "telephone_number": "907-235-8101",
            "fax_number": "907-235-0253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 BARTLETT STREET",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996037005",
            "telephone_number": "907-235-8101",
            "fax_number": "907-235-0253"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4251 Bartlett St",
            "address_purpose": "LOCATION",
            "city": "Homer",
            "state": "AK",
            "postal_code": "996037006",
            "country_code": "US",
            "telephone_number": "907-235-0201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3714 Greatland St",
            "address_purpose": "LOCATION",
            "city": "Homer",
            "state": "AK",
            "postal_code": "996037522",
            "country_code": "US",
            "telephone_number": "907-235-7202",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "263 W Fairview Ave",
            "address_purpose": "LOCATION",
            "city": "Homer",
            "state": "AK",
            "postal_code": "996037032",
            "country_code": "US",
            "telephone_number": "907-435-3070",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4201 Bartlett St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Homer",
            "state": "AK",
            "postal_code": "996037015",
            "country_code": "US",
            "telephone_number": "907-235-0310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3726 Lake St Ste G",
            "address_purpose": "LOCATION",
            "city": "Homer",
            "state": "AK",
            "postal_code": "996037663",
            "country_code": "US",
            "telephone_number": "907-235-0370",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4300 Bartlett St",
            "address_purpose": "LOCATION",
            "city": "Homer",
            "state": "AK",
            "postal_code": "996037005",
            "country_code": "US",
            "telephone_number": "907-226-5630",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4201 Bartlett St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Homer",
            "state": "AK",
            "postal_code": "996037015",
            "country_code": "US",
            "telephone_number": "907-235-0229",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "205 W Fairview Ave",
            "address_purpose": "LOCATION",
            "city": "Homer",
            "state": "AK",
            "postal_code": "996037032",
            "country_code": "US",
            "telephone_number": "907-226-5600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4201 Bartlett St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Homer",
            "state": "AK",
            "postal_code": "996037015",
            "country_code": "US",
            "telephone_number": "907-235-0900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4136 Bartlett St",
            "address_purpose": "LOCATION",
            "city": "Homer",
            "state": "AK",
            "postal_code": "996037001",
            "country_code": "US",
            "telephone_number": "907-235-8586",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTH PENINSULA HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-29",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "907-235-0241",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QC0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Critical Access Hospital",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1582637",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1582664",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1687518",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1701931",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1005653",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1020634",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1738615",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1005654",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1028527",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1687514",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1005186",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1755753",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1756683",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• South Peninsula Behavioral Health Services Inc (Community Mental Health Center)
• South Peninsula Behavioral Health SVCS Inc
• South Peninsula General Surgery LLC
• South Peninsula Hospital, Inc
• South Peninsula Hospital, Inc
• South Pennisula Hospital Phcy (South Peninsula Hospital Pharmacy)
• Michael J Spencer
• Sprout Family Services, Inc.
• Serena Stark
• Meagan Stead, APRN

• Critical Access Hospital in Homer, AK
• Providers in Homer, AK by specialty
• Critical Access Hospital in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.