NPIMap

Organization Active NPI

Bristol Bay Area Health Corporation

  • Clinic/Center
  • Chignik Bay, AK
National Provider Identifier
1871654582
Registry record updated Oct 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
BRISTOL BAY AREA HEALTH CORPORATION
Practice address
90 Main Street
Chignik Bay, AK 99564
Phone
(907) 842-5201
Fax
(907) 842-9250
NPI assigned
Dec 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2023

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) 842-5201

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

90 Main Street
Chignik Bay, AK 99564

Mailing address

PO Box 130
Dillingham, AK 99576-0130
Phone (907) 842-5201

Other names 1

  • CHIGNIK BAY CLINIC Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

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…
O20190304000785 TX Part B Supplier - Mass Immunization (Roster Biller Only) 5890699920 21 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Goodnews Bay, AK; Twin Hills, AK; Togiak, AK; South Naknek, AK; Port Heiden, AK; Platinum, AK; Pilot Point, AK; Perryville, 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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
02D0641824Chignik Bay Subregional Clinic90 Main Street, Chignik, AK 99564Certificate of waiverFeb 28, 2028

National Provider Directory

National Provider Directory

Practitioners 319

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 319

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696550400000",
    "number": "1871654582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "DILLINGHAM",
            "state": "AK",
            "postal_code": "995760130",
            "telephone_number": "907-842-5201",
            "fax_number": "907-842-9250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 MAIN STREET",
            "city": "CHIGNIK BAY",
            "state": "AK",
            "postal_code": "99564",
            "telephone_number": "907-842-5201",
            "fax_number": "907-842-9250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRISTOL BAY AREA HEALTH CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-05",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "907-842-5201",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHIGNIK BAY CLINIC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "CHIGNIK BAY CLINIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chignik Bay, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.