NPIMap

Organization Active NPI

City of Valdez

Doing business as Providence Valdez Medical Center

  • Critical Access Hospital
  • Valdez, AK
National Provider Identifier
1750485488
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
CITY OF VALDEZ
Doing business as
Providence Valdez Medical Center
Practice address
911 Meals
Valdez, AK 99686-0550
Phone
(907) 835-2249
Fax
(907) 834-1890
NPI assigned
Sep 12, 2006
Last updated
May 13, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
CITY OF VALDEZAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Authorized official

Name
Donald Wayne Anderson Jr.
Title
Assistant Secretary of Enrollments
Phone
(425) 358-9786

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X AK Primary
Family Medicine Physician 207Q00000X

Addresses

Primary practice location

911 Meals
Valdez, AK 99686-0550

Mailing address

PO Box 550
Valdez, AK 99686-0550
Phone (907) 835-2249

Other identifiers 2

IdentifierTypeStateIssuer
HS027OPMedicaidAK
HS027IPMedicaidAK

Other names 1

  • PROVIDENCE VALDEZ MEDICAL CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061104000452 AK Part A Provider - Critical Access Hospital 3577514694 Receives reassigned benefits from 21 practitioners
Practice locations: Valdez, AK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1750485488. Details of each certification follow.

Hospital certification: CCN 021301

Legal name
CITY OF VALDEZ
Doing business as
PROVIDENCE VALDEZ MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Aug 1, 2000
Last certification
Nov 17, 2021
Beds
11
Ownership / control type
Local
Organization structure
OtherNon-profit
Incorporated
Jun 11, 1901 in AK
Enrollment address
911 Meals Ave
Valdez, AK 99686
Main/Primary Hospital Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

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

  • City of Valdez

    dba Providence Valdez Medical Center

    • Medicare Defined Swing Bed Hospital Unit
    • Valdez, AK
    • NPI 1336247824

    3577514694

    Same PAC ID
  • City of Valdez

    dba Providence Valdez Medical Center

    • Critical Access Hospital Clinic/Center
    • Valdez, AK
    • NPI 1427424282

    3577514694

    Same PAC ID
  • City of Valdez

    dba Providence Valdez Medical Center

    • Skilled Nursing Facility
    • Valdez, AK
    • NPI 1790715928

    3577514694

    Same PAC ID

Care Compare: Hospital

Medicare Care Compare
Listed as
Providence Valdez Medical CenterCCN 021301 · All quality measures
Type
Critical Access Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
City of Valdez3 organizations share this tax ID, including this one
Part of
City of Valdez

Other organizations with this tax ID 2

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

  • City of Valdez

    dba Providence Valdez Medical Center

    • Medicare Defined Swing Bed Hospital Unit
    • Valdez, AK
    • NPI 1336247824
    NPD tax ID
  • City of Valdez

    dba Providence Valdez Medical Center

    • Skilled Nursing Facility
    • Valdez, AK
    • NPI 1790715928
    NPD tax ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 24

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

NameRoleSinceShare
Diane L Hejna Individual Corporate DirectorBoard Member Jul 1, 2016
Richard S Blair Individual Corporate DirectorBoard Member - Chairman Jul 1, 2016
Marvin O'Quinn Individual Corporate DirectorDirector Jan 1, 2024
Pauline Doucet Individual W-2 Managing EmployeeAd; May 29, 2025
Linda Buck Individual Corporate DirectorBoard Member Jan 1, 2025
Providence Health & Services - Washington Organization, Renton, WA For-profit Operational/Managerial Control Jan 1, 2005 100%
Mary E Lyons Individual Corporate DirectorBoard Member Jul 1, 2016
Nathan Duval Individual W-2 Managing EmployeeCity Manager May 6, 2025
City of Valdez Organization, Valdez, AK 5% Or Greater Direct Ownership Interest Jan 1, 2005 100%
James Travis Individual W-2 Managing EmployeeFinancial Executive Mar 30, 2026
Phyllis M Hughes Individual Corporate DirectorDirector Jan 1, 2014
Rogelio Riojas Individual Corporate DirectorBoard Member Jan 1, 2025
James Martin Individual Corporate OfficerAssistant Treasurer Jan 13, 2023
Charles Wallace Sorenson Individual Corporate DirectorBoard of Directors Jan 1, 2019
Donald Wayne Anderson Individual Corporate OfficerAssistant Secretary of Enrollments Jan 1, 2017
Gregory David Hoffman Individual Corporate OfficerCfo/Treasurer Oct 1, 2020
Isiaah D Crawford Individual Corporate DirectorBoard Member Feb 1, 2012
Donna Markham Individual Corporate DirectorDirector Jan 1, 2024
Michael W Murphy Individual Corporate DirectorBoard of Directors Jan 1, 2020
Mary Beth Kingston Individual Corporate DirectorBoard Member Sep 1, 2022
Eric D Sprunk Individual Corporate DirectorBoard Member Jan 1, 2022
Anna R Newsom Individual Corporate OfficerCorporate Secretary May 13, 2022
Darryl Elmouchi Individual Corporate DirectorBoard Member Apr 1, 2025
Karin Dufault Individual Corporate DirectorBoard Member Jan 1, 2025

Owners & managing parties with NPI records 2

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

Facilities with the same owner 139

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

View all 139

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

Affiliated clinicians 32

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747094400000",
    "number": "1750485488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "VALDEZ",
            "state": "AK",
            "postal_code": "996860550",
            "telephone_number": "907-835-2249",
            "fax_number": "907-834-1890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 MEALS",
            "city": "VALDEZ",
            "state": "AK",
            "postal_code": "996860550",
            "telephone_number": "907-835-2249",
            "fax_number": "907-834-1890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF VALDEZ",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CITY OF VALDEZ",
        "enumeration_date": "2006-09-12",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY OF ENROLLMENTS",
        "authorized_official_telephone_number": "425-358-9786",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "AK",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HS027OP",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HS027IP",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROVIDENCE VALDEZ MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Valdez, AK

Sources for this page

Verify at the official NPI Registry.