NPIMap

Organization Active NPI

Central Peninsula General Hospital

Doing business as Central Peninsula Family Practice Fireweed

  • Rural Acute Care Hospital
  • Soldotna, AK
National Provider Identifier
1831404805
Registry record updated Jun 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Acute Care HospitalTaxonomy code 282NR1301X
Legal business name
CENTRAL PENINSULA GENERAL HOSPITAL
Doing business as
Central Peninsula Family Practice Fireweed
Practice address
245 N Binkley St
Suite 101
Soldotna, AK 99669-7523
Phone
(907) 714-4111
Fax
(907) 714-4696
NPI assigned
Aug 13, 2010
Last updated
Jun 4, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2012

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

Authorized official

Name
Mr. Rick Davis
Title
Ceo
Phone
(907) 714-4723

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Acute Care Hospital 282NR1301X NU Primary

Addresses

Primary practice location

245 N Binkley St
Suite 101
Soldotna, AK 99669-7523

Mailing address

250 Hospital PL
Soldotna, AK 99669-7559

Other identifiers 3

IdentifierTypeStateIssuer
155OtherAKBLUE CROSS
MDG830MedicaidAK
0004OtherAKTRIWEST

Other names 1

  • Central Peninsula Family Practice Fireweed Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040310000598 AK Part B Supplier - Clinic/Group Practice 4587552575 Receives reassigned benefits from 136 practitioners
19 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Soldotna, AK; Kenai, AK
O20050609000176 AK Part A Provider - Hospital 4587552575 18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Soldotna, AK; Kenai, AK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1831404805. Details of each certification follow.

Hospital certification: CCN 020024

Legal name
CENTRAL PENINSULA GENERAL HOSPITAL INC
Doing business as
CENTRAL PENINSULA GENERAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Aug 5, 1971
Last certification
Aug 3, 2006
Beds
49
Ownership / control type
Other
Organization structure
CorporationProprietary
Incorporated
Jan 1, 1993 in AK
Enrollment address
250 Hospital PL
Soldotna, AK 99669-7559
Hospital subgroups
Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 20

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

View all 20

Care Compare: Hospital

Medicare Care Compare
Listed as
Central Peninsula General HospitalCCN 020024 · All quality measures
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Other
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

245 N Binkley St
Ste 101
Soldotna, AK 99669
Phone (907) 714-4111

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Carrie Couey Individual Corporate DirectorBoard of Directors Jan 1, 2020
Shaun Patrick Keef Individual Corporate OfficerCeo Jan 11, 2019
W-2 Managing EmployeeCeo Jan 11, 2019
Michael Reyes Individual Corporate DirectorBoard of Directors Jan 1, 2023
Paul Ostrander Individual Corporate DirectorBoard of Directors Jan 1, 2022
Karl Hertz Individual Corporate OfficerCoo Jun 16, 2025
Central Peninsula General Hospital Inc Organization, Soldotna, AK Non-profit Operational/Managerial Control Nov 26, 2007
Trena Richardson Individual Corporate DirectorBoard of Directors Jan 1, 2020
Jay S Rohloff Individual Corporate DirectorBoard of Directors Jan 1, 2021
Jesse J Kincaid Individual Corporate DirectorBoard of Directors Jan 1, 2022
Shanda Rochelle Richards Individual W-2 Managing EmployeeRevenue Cycle Director Feb 8, 2021
Bradley T Cross Individual Corporate DirectorBoard of Directors Jan 1, 2023
Max Best Individual Corporate DirectorBoard of Directors Jan 1, 2021
Stephanie Queen Individual Corporate DirectorBoard of Directors Jan 1, 2023
Angela Hinnegan Individual Corporate OfficerCfo Aug 1, 2025
Barb Belloumini Individual Corporate Director Jan 1, 2025
Silverio Mattero Individual Corporate DirectorBoard of Directors Jan 1, 2022

Owners & managing parties with NPI records 7

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 387

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 387

NPI Registry JSON

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

{
    "created_epoch": "1281657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338768000000",
    "number": "1831404805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 HOSPITAL PL",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 N BINKLEY ST",
            "address_2": "SUITE 101",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697523",
            "telephone_number": "907-714-4111",
            "fax_number": "907-714-4696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL PENINSULA GENERAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-13",
        "last_updated": "2012-06-04",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "RICK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "907-714-4723",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "155",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MDG830",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIWEST",
            "identifier": "0004",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Peninsula Family Practice Fireweed",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Soldotna, AK

Sources for this page

Verify at the official NPI Registry.