NPIMap

Organization Active NPI

Bartlett Regional Hospital

Doing business as Southeast Physician Services

  • Community/Behavioral Health Agency
  • Juneau, AK
National Provider Identifier
1780376533
Registry record updated Nov 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
BARTLETT REGIONAL HOSPITAL
Doing business as
Southeast Physician Services
Practice address
3240 Hospital Dr
Juneau, AK 99801-7808
Phone
(907) 796-8498
NPI assigned
May 22, 2023
Last updated
Nov 21, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
BARTLETT REGIONAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 21, 2023

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

Authorized official

Name
Joseph Wanner
Title
Chief Financial Officer
Phone
(907) 796-8402

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

3240 Hospital Dr
Juneau, AK 99801-7808

Mailing address

3260 Hospital Dr
Juneau, AK 99801-7808
Phone (907) 796-8900

Other names 2

  • Southeast Physician Services Doing business as
  • 1115 MH Waiver Other name

National Provider Directory

National Provider Directory
Tax ID family
Southeast Physicians SE3 organizations share this tax ID, including this one
Part of
Southeast Physicians SE

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": "1684713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700524800000",
    "number": "1780376533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3260 HOSPITAL DR",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998017808",
            "telephone_number": "907-796-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3240 HOSPITAL DR",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998017808",
            "telephone_number": "907-796-8498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARTLETT REGIONAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BARTLETT REGIONAL HOSPITAL",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A",
        "authorized_official_last_name": "WANNER",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "907-796-8402"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeast Physician Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southeast Physician Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "1115 MH Waiver",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Juneau, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; 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.