NPIMap

Organization Active NPI

Bristol Bay Area Health Corporation

  • Critical Access Hospital
  • Dillingham, AK
National Provider Identifier
1831255421
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
BRISTOL BAY AREA HEALTH CORPORATION
Practice address
6000 Kanakanak Rd
Dillingham, AK 99576
Phone
(907) 842-6400
Fax
(907) 842-9203
NPI assigned
Dec 28, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Robert Clark
Title
Ceo
Phone
(907) 842-9502

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X Primary

Addresses

Primary practice location

6000 Kanakanak Rd
Dillingham, AK 99576

Mailing address

6000 Kanakanak Rd
P O Box 130
Dillingham, AK 99576
Phone (907) 842-6400

Other names 1

  • KANAKANAK HOSPITAL Other name

Medicare participation

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

Enrollment records 1

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…

Other NPIs on the same Medicare enrollment 38

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

View all 38

National Provider Directory

National Provider Directory
Tax ID family
Bristol Bay Area43 organizations share this tax ID, including this one

Other organizations with this tax ID 42

Organizations that report the same tax identification number in the National Provider Directory.

View all 42

Practitioners & affiliated clinicians

Practitioners 20

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 20

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831255421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 KANAKANAK RD",
            "address_2": "P O BOX 130",
            "city": "DILLINGHAM",
            "state": "AK",
            "postal_code": "99576",
            "telephone_number": "907-842-6400",
            "fax_number": "907-842-9203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 KANAKANAK RD",
            "city": "DILLINGHAM",
            "state": "AK",
            "postal_code": "99576",
            "telephone_number": "907-842-6400",
            "fax_number": "907-842-9203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRISTOL BAY AREA HEALTH CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "907-842-9502",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KANAKANAK HOSPITAL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dillingham, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.