NPIMap

Organization Active NPI

Yukon Kuskokwim Health Corp

  • Chronic Disease Hospital
  • Bethel, AK
National Provider Identifier
1710104302
Registry record updated Mar 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Chronic Disease HospitalTaxonomy code 281P00000X
Legal business name
YUKON KUSKOKWIM HEALTH CORP
Practice address
829 Chief Eddie Hoffman Hwy
Suite 528
Bethel, AK 99559-0528
Phone
(907) 543-6000
Fax
(907) 543-6117
NPI assigned
Apr 18, 2007
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
Ambulatory Surgical Clinic/Center 261QA1903X
Chronic Disease Hospital 281P00000X Primary

Addresses

Primary practice location

829 Chief Eddie Hoffman Hwy
Suite 528
Bethel, AK 99559-0528

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
HS05ASMedicaidAK

National Provider Directory

National Provider Directory
Tax ID family
Edith Kawagley Memorial32 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": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204502400000",
    "number": "1710104302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 CHIEF EDDIE HOFFMAN HWY",
            "address_2": "SUITE 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": "SUITE 528",
            "city": "BETHEL",
            "state": "AK",
            "postal_code": "995590528",
            "telephone_number": "907-543-6000",
            "fax_number": "907-543-6117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YUKON KUSKOKWIM HEALTH CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "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": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "281P00000X",
            "taxonomy_group": "",
            "desc": "Chronic Disease Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HS05AS",
            "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.