NPIMap

Organization Active NPI

Native Village of Eyak

  • Community Health Clinic/Center
  • Cordova, AK
National Provider Identifier
1821074535
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
License
703435 Issued in AK
Legal business name
NATIVE VILLAGE OF EYAK
Practice address
705 2ND Street
Cordova, AK 99574
Phone
(907) 424-3622
Fax
(907) 424-3681
NPI assigned
Dec 15, 2005
Last updated
Sep 14, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

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

Authorized official

Name
Cindy Bradford, LNHA
Title
Operations Manager
Phone
(907) 424-3622

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X 703435 AK Primary

Addresses

Primary practice location

705 2ND Street
Cordova, AK 99574

Mailing address

PO Box 2290
Cordova, AK 99574-2290
Phone (907) 424-3622

Other names 1

  • Ilanka Community Health Center Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040116000589 TX Part B Supplier - Clinic/Group Practice 1052220878 Receives reassigned benefits from 11 practitioners
Practice locations: Cordova, AK

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: arigby@direct.eyak-nsn.gov
  • Direct secure messaging: bhead@direct.eyak-nsn.gov
  • Direct secure messaging: biutzi@direct.eyak-nsn.gov
  • Direct secure messaging: cbejes@direct.eyak-nsn.gov
  • Direct secure messaging: lmahoozi@direct.eyak-nsn.gov

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631577600000",
    "number": "1821074535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2290",
            "city": "CORDOVA",
            "state": "AK",
            "postal_code": "995742290",
            "telephone_number": "907-424-3622",
            "fax_number": "907-424-3275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 2ND STREET",
            "city": "CORDOVA",
            "state": "AK",
            "postal_code": "99574",
            "telephone_number": "907-424-3622",
            "fax_number": "907-424-3681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIVE VILLAGE OF EYAK",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-15",
        "last_updated": "2021-09-14",
        "certification_date": "2021-08-26",
        "status": "A",
        "authorized_official_last_name": "BRADFORD",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "907-424-3622",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "AK",
            "license": "703435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ilanka Community Health Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Ilanka Community Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cordova, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.