NPIMap

Organization Active NPI

Mt.Sanford Tribal Consortium

  • Nurse Practitioner
  • Chistochina, AK
National Provider Identifier
1679993026
Registry record updated Apr 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
MT.SANFORD TRIBAL CONSORTIUM
Practice address
Milepost 33 Tok Cutoff
Chistochina, AK 99586-0000
Phone
(907) 822-3599
NPI assigned
Apr 24, 2014
Last updated
Apr 24, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2014

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

Authorized official

Name
Joseph Beaty
Title
Billing Agent
Phone
(907) 770-2380

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

Milepost 33 Tok Cutoff
Chistochina, AK 99586-0000

Mailing address

PO Box 357
Gakona, AK 99586-0357

Other names 1

  • Chistochina Clinic Other name

National Provider Directory

National Provider Directory
Tax ID family
Chistochina Clinic3 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.

NPI Registry JSON

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

{
    "created_epoch": "1398297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398297600000",
    "number": "1679993026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 357",
            "city": "GAKONA",
            "state": "AK",
            "postal_code": "995860357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MILEPOST 33 TOK CUTOFF",
            "city": "CHISTOCHINA",
            "state": "AK",
            "postal_code": "995860000",
            "telephone_number": "907-822-3599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT.SANFORD TRIBAL CONSORTIUM",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-24",
        "last_updated": "2014-04-24",
        "status": "A",
        "authorized_official_last_name": "BEATY",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "BILLING AGENT",
        "authorized_official_telephone_number": "907-770-2380"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chistochina Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chistochina, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2014; 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.