Active NPI
Chugachmiut
- Community Health Clinic/Center
- Chenega, AK
National Provider Identifier
1700057676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Clinic/Center
- Legal business name
- CHUGACHMIUT
- Practice address
- 625 Main Street
Chenega, AK 99574-8029 - Phone
- (907) 573-5129
- Fax
- (907) 573-5148
- NPI assigned
- Mar 18, 2008
- Last updated
- Dec 15, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kelley Baker
- Title
- Health Services Division Director
- Phone
- (907) 562-4155
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Clinic/Center | 261QC1500X | NU | Primary |
Addresses
Primary practice location
625 Main Street
Chenega, AK 99574-8029
Mailing address
1840 Bragaw St Ste 110
Anchorage, AK 99508-3463
Phone (907) 562-4155
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1021383 | Medicaid | AK |
Other names 1
- Arch Priest Nicholas Kompkoff Clinic
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AK, TX
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040323001690 | AK | Part B Supplier - Clinic/Group Practice | 0648161141 |
Receives reassigned benefits from 9 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Chenega Bay, AK; Tatitlek, AK; Seward, AK; Nanwalek, AK; Port Graham, AK |
| O20250516003075 | TX | Part B Supplier - Clinic/Group Practice | 0648161141 |
Receives reassigned benefits from 3 practitioners 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Anchorage, AK; Chenega, AK; Nanwalek, AK; Port Graham, AK; Seward, AK; Tatitlek, AK |
Other NPIs on the same Medicare enrollment 6
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Chugachmiut Regional Health Center
- Community Health Clinic/Center
- Seward, AK
- NPI 1194889287
O20040323001690, O20250516003075
-
dba Chugachmiut Regional Health Center
- Community Health Worker
- Seward, AK
- NPI 1750618856
O20250516003075
-
dba Tatitlek Clinic
- Community Health Clinic/Center
- Tatitlek, AK
- NPI 1801067723
O20040323001690, O20250516003075
-
dba Nanwalek Clinic
- Community Health Clinic/Center
- Nanwalek, AK
- NPI 1902077829
O20040323001690, O20250516003075
-
dba Anesia Anahonak Moonin Clinic
- Community Health Clinic/Center
- Port Graham, AK
- NPI 1902077837
O20040323001690, O20250516003075
National Provider Directory
National Provider Directory- Tax ID family
- Chugachmiut
Other organizations with this tax ID 7
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Chugachmiut Regional Health Center
- Community Health Clinic/Center
- Seward, AK
- NPI 1194889287
-
dba Chugachmiut Regional Health Center
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
- Seward, AK
- NPI 1649477126
-
- Community/Behavioral Health Agency
- Anchorage, AK
- NPI 1730565045
-
dba Chugachmiut Regional Health Center
- Community Health Worker
- Seward, AK
- NPI 1750618856
Practitioners & affiliated clinicians
Practitioners 7
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.
-
- Family Nurse Practitioner
- Nanwalek, AK
- NPI 1881063295
-
- Family Nurse Practitioner
- Sherman, TX
- NPI 1740678556
-
- Community Health Worker
- Chenega Bay, AK
- NPI 1982835658
-
- Community Health Worker
- Chenega Bay, AK
- NPI 1710162763
-
- Community Health Worker
- Chenega Bay, AK
- NPI 1356000889
-
- Community Health Worker
- Chenega Bay, AK
- NPI 1790956886
-
- Dental Therapist
- Seward, AK
- NPI 1205265345
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205798400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1639526400000",
"number": "1700057676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1840 BRAGAW ST STE 110",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995083463",
"telephone_number": "907-562-4155",
"fax_number": "907-563-2891"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 MAIN STREET",
"city": "CHENEGA",
"state": "AK",
"postal_code": "995748029",
"telephone_number": "907-573-5129",
"fax_number": "907-573-5148"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHUGACHMIUT",
"organizational_subpart": "NO",
"enumeration_date": "2008-03-18",
"last_updated": "2021-12-15",
"certification_date": "2021-12-14",
"status": "A",
"authorized_official_last_name": "BAKER",
"authorized_official_first_name": "KELLEY",
"authorized_official_title_or_position": "HEALTH SERVICES DIVISION DIRECTOR",
"authorized_official_telephone_number": "907-562-4155"
},
"taxonomies": [
{
"code": "261QC1500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Community Health",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1021383",
"state": "AK"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Arch Priest Nicholas Kompkoff Clinic",
"code": "5",
"type": "Other Name"
},
{
"organization_name": "Arch Priest Nicholas Kompkoff Clinic",
"code": "5",
"type": "Other Name"
}
]
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.