NPIMap

Organization Active NPI

Yukon Kuskokwim Health Corporation

  • Health Service Clinic/Center
  • St. Mary's, AK
National Provider Identifier
1851574826
Registry record updated Dec 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
YUKON KUSKOKWIM HEALTH CORPORATION
Practice address
310 Hospital Road
St. Mary's Subregional Clinic
St. Mary's, AK 99658
Phone
(907) 543-6000
Fax
(907) 543-6117
NPI assigned
Dec 12, 2007
Last updated
Dec 12, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
YKHC-ST. MARY'S SUBREGIONAL CLINICAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 12, 2007

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

Authorized official

Name
Mr. Gene Peltola
Title
Ceo
Phone
(907) 543-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X NU Primary

Addresses

Primary practice location

310 Hospital Road
St. Mary's Subregional Clinic
St. Mary's, AK 99658

Mailing address

4700 Business Park Blvd
Aeromed Office
Anchorage, AK 99503-7176
Phone (907) 543-6000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040407001515 TX Part B Supplier - Clinic/Group Practice 5193718765 Receives reassigned benefits from 36 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bethel, AK; Toksook, AK; St. Mary's, AK; Hooper Bay, AK; Emmonak, AK; Aniak, AK

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory
Part of
Yukon-Kuskokwim HLTH Corp

Practitioners & affiliated clinicians

Practitioners 3

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": "1197417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197417600000",
    "number": "1851574826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 BUSINESS PARK BLVD",
            "address_2": "AEROMED OFFICE",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995037176",
            "telephone_number": "907-543-6000",
            "fax_number": "907-543-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 HOSPITAL ROAD",
            "address_2": "ST. MARY'S SUBREGIONAL CLINIC",
            "city": "ST. MARY'S",
            "state": "AK",
            "postal_code": "99658",
            "telephone_number": "907-543-6000",
            "fax_number": "907-543-6117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YUKON KUSKOKWIM HEALTH CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "YKHC-ST. MARY'S SUBREGIONAL CLINIC",
        "enumeration_date": "2007-12-12",
        "last_updated": "2007-12-12",
        "status": "A",
        "authorized_official_last_name": "PELTOLA",
        "authorized_official_first_name": "GENE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "907-543-6000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St. Mary's, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2007; 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.