City of Valdez
Organization Active NPI Skilled Nursing Facility · Valdez, AK
NPI 1790715928 · NPPES record last updated May 13, 2025
Key facts
- NPI
- 1790715928
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- NOT NUMBERED (AK)
- Legal business name
- CITY OF VALDEZ
- Practice address
- 911 Meals Avenue
Valdez, AK 99686 - Phone
- (907) 835-2249
- Fax
- (907) 834-1890
- NPI assigned
- Jul 4, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- CITY OF VALDEZ
Authorized official
- Name
- Mr. Donald Anderson Jr.
- Title
- Assistant Secretary of Enrollments
- Phone
- (425) 358-9786
Owners & managing parties with NPI records 2
-
Kathleen G Todd, M.D.
Other NPIs with the same Medicare PAC ID 3
Corporate family (same tax ID) 2
Member of 1
Facilities with the same owner 139
Practitioners 14
-
Kathleen G Todd, M.D.
-
John S Cullen, M.D.
-
Tara D Lathrop, M.D.
-
Amanda J Lowe, MD
-
Bradley W Wine, MD
-
Karoly John Dobay III, D.O.
-
Anne M Flint, MD
-
Christine Marie Kneisel, M.D.
-
Megan Rayman, M.D.
-
Kenneth Walker Rudd II, MD, MPH, DABFM
Medicare Care Compare: Nursing home
- Listed as
- Providence Valdez Medical Center
- Overall star rating
- ★★★☆☆ 3 of 5
- Health inspections
- ★★★☆☆ 3 of 5
- Staffing
- ★★★★☆ 4 of 5
- Quality measures
- ★★★☆☆ 3 of 5
- Type
- Medicare and Medicaid
- Ownership
- Government - City
- Certified
- Oct 3, 2005
- Medicare certification status
- Active
- Certified beds
- 10 · 8.9 residents per day on average
- Chain
- Providence Health & Services
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AK
Skilled nursing facility certification: CCN 025034
- Legal name
- CITY OF VALDEZ
- Doing business as
- PROVIDENCE VALDEZ MEDICAL CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Oct 3, 2005
- Last certification
- Mar 6, 2025
- Beds
- 10
- Ownership / control type
- City
- Organization structure
- Other · Non-profit
- Incorporated
- Jun 11, 1901 in AK
- Enrollment address
- 911 Meals Ave
Valdez, AK 99686 - Nursing home name
- PROVIDENCE VALDEZ MEDICAL CENTER
- Affiliated entity
- PROVIDENCE HEALTH & SERVICES
All disclosed owners & managing parties 9
| Name | Role | Since | Share |
|---|---|---|---|
| Pauline Doucet |
Operational/Managerial Control | Jan 1, 2005 | |
| Adp of the SNF | May 29, 2025 | ||
| Mary Beth Formby |
Operational/Managerial Control | Nov 12, 2025 | |
| Providence Health & Services - Washington |
Operational/Managerial Control | Jan 1, 2025 | |
| Adp of the SNF | Jun 30, 2025 | ||
| Nathan Duval |
Operational/Managerial Control | May 6, 2025 | |
| Adp of the SNF | May 6, 2025 | ||
| City of Valdez |
5% Or Greater Direct Ownership Interest | Jan 1, 2005 | 100% |
| Adp of the SNF | Jan 1, 2005 | ||
| James Martin |
Corporate Officer |
Jan 13, 2023 | |
| Operational/Managerial Control | Jan 13, 2023 | ||
| Adp of the SNF | Jan 13, 2023 | ||
| Donald Wayne Anderson |
Corporate Officer |
Jan 1, 2017 | |
| Operational/Managerial Control | Jan 1, 2017 | ||
| Adp of the SNF | Jan 1, 2017 | ||
| Gregory David Hoffman |
Operational/Managerial Control | Oct 1, 2020 | |
| Adp of the SNF | Oct 1, 2020 | ||
| Kathleen G Todd |
Operational/Managerial Control | Jun 5, 2023 | |
| Adp of the SNF | Jun 5, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20121108000601 | AK | Part a Provider - Skilled Nursing Facility | 3577514694 | Practice locations: Valdez, AK |
National Provider Directory
- Tax ID family
- City of Valdez
- Part of
- City of Valdez
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | NOT NUMBERED | AK | Yes |
Addresses
Primary practice location
911 Meals Avenue
Valdez, AK 99686
Mailing address
PO Box 550
Valdez, AK 99686-0550
Phone (907) 835-2249
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LT2123 | Medicaid | AK |
Other names
- PROVIDENCE VALDEZ MEDICAL CENTER
Other providers in Valdez, AK
- Carr-Gottstein Foods Co
- City of Valdez
- City of Valdez
- City of Valdez
- City of Valdez
- City of Valdez
- City of Valdez
- Coral A Clark
- Dustin E Clark
- Joel Ray Clark
All providers in Valdez, AK · Skilled Nursing Facility in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 13, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.