NPIMap

Bristol Bay Area Health Corporation

Organization Active NPI Medicare Defined Swing Bed Hospital Unit · Dillingham, AK

NPI 1770645202 · NPPES record last updated Apr 4, 2013

Key facts

NPI
1770645202
Entity type
Organization (NPI type 2)
Primary specialty
Medicare Defined Swing Bed Hospital Unit 275N00000X
Legal business name
BRISTOL BAY AREA HEALTH CORPORATION
Practice address
6000 Kanakanak Rd
Dillingham, AK 99576-0130
Phone
(907) 842-5201
Fax
(907) 842-9250
NPI assigned
Dec 14, 2006
Organization subpart
No

Authorized official

Name
Mr. Robert Clark
Title
Ceo
Phone
(907) 842-5201

Owners & managing parties with NPI records 3

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

Owned or controlled facilities with NPI records 3

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

Other NPIs on the same Medicare enrollment 38

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 38

Other NPIs with the same Medicare PAC ID 3

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

Member of 1

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

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

Facilities with the same owner 1

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

Practitioners 425

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 425

Affiliated clinicians 1

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in TX, AK

Hospital certification: CCN 02Z309

Legal name
BRISTOL BAY AREA HEALTH CORPORATION
Doing business as
KANAKANAK HOSPITAL
Organization structure
Other · Non-profit
Incorporated
Jul 10, 1973 in AK
Enrollment address
6000 Kanakanak Rd
Dillingham, AK 99576-0130
Other Hospital Practice Location

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Nathaniel Hall
Individual 		W-2 Managing Employee
Chief Human Resources Officer		 Mar 30, 2020 5%
Bristol Bay Area Health Corporation
Organization · Dillingham, AK
Corporation 		5% Or Greater Direct Ownership Interest Oct 14, 2011 100%
Robert Clark
Individual 		Corporate Director
Ceo/President		 Oct 25, 2004

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Kanakanak Hospital
Dillingham, AK · CCN 021309		 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 14, 2011

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031120000998 TX Part B Supplier - Clinic/Group Practice 5890699920 Receives reassigned benefits from 432 practitioners
44 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lebelock, AK; Manokotak, AK; Goodnews Bay, AK; Naknek, AK; New Stuyahok, AK; Perryville, AK; Pilot Point, AK; Platinum, AK…
O20220721002167 AK Part a Provider - Critical Access Hospital 5890699920 Practice locations: Dillingham, AK

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: jastalmaster@direct.bbahc.org
  • Direct secure messaging: megallo@direct.bbahc.org
  • Direct secure messaging: cmstordeur@direct.bbahc.org
  • Direct secure messaging: epoliver@direct.bbahc.org
  • Direct secure messaging: cmlink@direct.bbahc.org
  • Direct secure messaging: laschwietz@direct.bbahc.org
  • Direct secure messaging: blriley@direct.bbahc.org
  • Direct secure messaging: rntalaga@direct.bbahc.org
  • Direct secure messaging: djpowers@direct.bbahc.org
  • Direct secure messaging: jalynch@direct.bbahc.org
  • Direct secure messaging: msforbes@direct.bbahc.org
  • Direct secure messaging: albennett@direct.bbahc.org
  • Direct secure messaging: mjhaydel@direct.bbahc.org
  • Direct secure messaging: njmyers@direct.bbahc.org
  • Direct secure messaging: rijohnson@direct.bbahc.org
  • Direct secure messaging: jsstewart@direct.bbahc.org
  • Direct secure messaging: epdavis@direct.bbahc.org
  • Direct secure messaging: cmbritt@direct.anthc.org
  • Direct secure messaging: dapetteway@direct.bbahc.org
  • Direct secure messaging: srwambolt@direct.bbahc.org

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X Yes

Addresses

Primary practice location

6000 Kanakanak Rd
Dillingham, AK 99576-0130

Mailing address

PO Box 130
Dillingham, AK 99576-0130
Phone (907) 842-5201

Other providers in Dillingham, AK

All providers in Dillingham, AK · Medicare Defined Swing Bed Hospital Unit in Alaska

Sources for this page

Verify at the official NPI Registry.