NPIMap

Organization Active NPI

Maniilaq Association

Doing business as Maniilaq Health Center

  • Community Health Worker
  • Kotzebue, AK
National Provider Identifier
1801296744
Registry record updated Aug 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
004-437-IV Issued in AK
Legal business name
MANIILAQ ASSOCIATION
Doing business as
Maniilaq Health Center
Practice address
436 5TH Avenue Ted Stevens Way
Kotzebue, AK 99752-0043
Phone
(907) 442-7161
Fax
(907) 442-7307
NPI assigned
Aug 28, 2014
Last updated
Aug 28, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2014

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

Authorized official

Name
Paul John Hansen
Title
Administrator
Phone
(907) 442-3321

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X 004-437-IV AK Primary

Addresses

Primary practice location

436 5TH Avenue Ted Stevens Way
Kotzebue, AK 99752-0043

Mailing address

436 5TH Ave. Ted Steven's Way
PO Box 43
Kotzebue, AK 99752
Phone (907) 442-7161

Other names 1

  • Maniilaq Health Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1409184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409184000000",
    "number": "1801296744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 5TH AVE. TED STEVEN'S WAY",
            "address_2": "PO BOX 43",
            "city": "KOTZEBUE",
            "state": "AK",
            "postal_code": "99752",
            "telephone_number": "907-442-7161",
            "fax_number": "907-442-7307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 5TH AVENUE TED STEVENS WAY",
            "city": "KOTZEBUE",
            "state": "AK",
            "postal_code": "997520043",
            "telephone_number": "907-442-7161",
            "fax_number": "907-442-7307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANIILAQ ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-28",
        "last_updated": "2014-08-28",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "907-442-3321"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "AK",
            "license": "004-437-IV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maniilaq Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kotzebue, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2014; 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.