Chugachmiut

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

Legal business name

CHUGACHMIUT

Doing business as

Nanwalek Clinic

Practice address

1 Maqiq Street
Nanwalek, AK 99603-6623

Phone

(907) 281-2250

Fax

(907) 281-2244

NPI assigned

Mar 19, 2008

Last updated

Dec 15, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kelley Baker

Title

Health Services Division Director

Phone

(907) 562-4155

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Nanwalek Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in AK, TX2 enrollments

Enrollment records 2

Other NPIs on the same Medicare enrollment 6

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

• Chugachmiut

  dba Chugachmiut Regional Health Center

  • Community Health Clinic/Center
  • Seward, AK
  • NPI 1194889287

  O20040323001690, O20250516003075

  Same enrollment
• Chugachmiut

  • Community Health Clinic/Center
  • Chenega, AK
  • NPI 1700057676

  O20040323001690, O20250516003075

  Same enrollment
• Chugachmiut

  • Community/Behavioral Health Agency
  • Anchorage, AK
  • NPI 1730565045

  O20250516003075

  Same enrollment
• Chugachmiut

  dba Chugachmiut Regional Health Center

  • Community Health Worker
  • Seward, AK
  • NPI 1750618856

  O20250516003075

  Same enrollment
• Chugachmiut

  dba Tatitlek Clinic

  • Community Health Clinic/Center
  • Tatitlek, AK
  • NPI 1801067723

  O20040323001690, O20250516003075

  Same enrollment
• Chugachmiut

  dba Anesia Anahonak Moonin Clinic

  • Community Health Clinic/Center
  • Port Graham, AK
  • NPI 1902077837

  O20040323001690, O20250516003075

  Same enrollment

Tax ID family

Chugachmiut8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

• Chugachmiut

  dba Chugachmiut Regional Health Center

  • Community Health Clinic/Center
  • Seward, AK
  • NPI 1194889287
  NPD tax ID
• Chugachmiut

  dba Chugachmiut Regional Health Center

  • Dental Clinic/Center
  • Seward, AK
  • NPI 1316147069
  NPD tax ID
• Chugachmiut

  dba Chugachmiut Regional Health Center

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Seward, AK
  • NPI 1649477126
  NPD tax ID
• Chugachmiut

  • Community Health Clinic/Center
  • Chenega, AK
  • NPI 1700057676
  NPD tax ID
• Chugachmiut

  • Community/Behavioral Health Agency
  • Anchorage, AK
  • NPI 1730565045
  NPD tax ID
• Chugachmiut

  dba Chugachmiut Regional Health Center

  • Community Health Worker
  • Seward, AK
  • NPI 1750618856
  NPD tax ID
• Chugachmiut

  dba Tatitlek Clinic

  • Community Health Clinic/Center
  • Tatitlek, AK
  • NPI 1801067723
  NPD tax ID

Practitioners 4

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.

• Jeffrey S Wolf

  • Family Nurse Practitioner
  • Seward, AK
  • NPI 1447654405
  NPD
• Quanah Rene Brewster

  • Community Health Worker
  • Nanwalek, AK
  • NPI 1235696717
  NPD (past)
• Elias E Kvasnikoff, CHA III C

  • Community Health Worker
  • Nanwalek, AK
  • NPI 1891926564
  NPD (past)
• Mandy M Wood, CHA IV

  • Community Health Worker
  • Nanwalek, AK
  • NPI 1164653838
  NPD (past)

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

{
    "created_epoch": "1205884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639526400000",
    "number": "1902077829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 BRAGAW ST STE 110",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995083463",
            "telephone_number": "907-562-4155",
            "fax_number": "907-563-2891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MAQIQ STREET",
            "city": "NANWALEK",
            "state": "AK",
            "postal_code": "996036623",
            "telephone_number": "907-281-2250",
            "fax_number": "907-281-2244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHUGACHMIUT",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-19",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-14",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "KELLEY",
        "authorized_official_title_or_position": "HEALTH SERVICES DIVISION DIRECTOR",
        "authorized_official_telephone_number": "907-562-4155"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1021384",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nanwalek Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Nanwalek Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Aquilina M Active
• Juanita Ann Bales
• Quanah Rene Brewster
• Elias E Kvasnikoff, CHA III C
• Emerson J Kvasnikoff
• Charlemagne Marie McMullen, CHP-C
• Nancy Radtke, B.H.P.
• Tania Virginia Lynn Romanoff

• Community Health Clinic/Center in Nanwalek, AK
• Providers in Nanwalek, AK by specialty
• Community Health Clinic/Center in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.