Central Peninsula General Hospital, Inc
Organization Active NPI Skilled Nursing Facility · Soldotna, AK
NPI 1922036060 · NPPES record last updated Dec 26, 2014
Key facts
- NPI
- 1922036060
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 736259 (AK)
- Legal business name
- CENTRAL PENINSULA GENERAL HOSPITAL, INC
- Practice address
- 232 Rockwell
Soldotna, AK 99669 - Phone
- (907) 262-2545
- Fax
- (907) 260-4590
- NPI assigned
- Jun 29, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- CENTRAL PENINSULA GENERAL HOSPITAL, INC
Authorized official
- Name
- Richard Davis
- Title
- Ceo
- Phone
- (907) 714-4723
Owners & managing parties with NPI records 7
-
Bradley T Cross, O.D.
-
Jesse Jennings Kincaid, M.D.
-
Michael L Reyes, MD
-
Jay Scott Rohloff, DDS
Owned or controlled facilities with NPI records 19
Other NPIs with the same Medicare PAC ID 2
Corporate family (same tax ID) 17
Facilities with the same owner 1
Practitioners 120
-
Samuel S. Adams, M.D.
-
Peter Ian Anderson, M.D.
-
John L Andreshak, M.D.
-
Naomi E Arenson, MD
-
Christine M Babcock, A.N.P.
-
Katherine M Becher, FNP
-
Erik Berger, M.D.
-
Leslie Erin Bonnet, CRNA
-
Devin T. Burrup, D.O.
-
Ian Burtenshaw, MD
-
Robert E Cadoff, M.D.
-
Theresa Chihuly, CRNA
-
Michael Sydenham Clarke, M.D.
-
Lindsay Brianne Cobb, M.D.
-
Richard Thomas Combs, PA-C
-
Sean Costello, MD
Affiliated clinicians 5
-
Katy Marie Sheridan, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Heritage Place
- Overall star rating
- ★★★★☆ 4 of 5
- Health inspections
- ★★★☆☆ 3 of 5
- Staffing
- ★★★★★ 5 of 5
- Quality measures
- ★★★★☆ 4 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jul 14, 1986
- Medicare certification status
- Active
- Certified beds
- 60 · 40.4 residents per day on average
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AK
Skilled nursing facility certification: CCN 025021
- Legal name
- CENTRAL PENINSULA GENERAL HOSPITAL INC
- Doing business as
- HERITAGE PLACE
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 14, 1986
- Last certification
- May 17, 2024
- Beds
- 60
- Ownership / control type
- Corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jan 1, 1973 in AK
- Enrollment address
- 232 W Rockwell Ave
Soldotna, AK 99669-7411 - Nursing home name
- HERITAGE PLACE
All disclosed owners & managing parties 17
| Name | Role | Since | Share |
|---|---|---|---|
| Carrie Couey |
Corporate Director |
Jan 1, 2020 | |
| Michael Reyes |
Corporate Director |
Jan 1, 2023 | |
| Michael MD Mullowney |
Operational/Managerial Control | Oct 23, 2013 | |
| Adp of the SNF | Sep 30, 2025 | ||
| Paul Ostrander |
Corporate Director |
Jan 1, 2022 | |
| Karl Hertz |
Corporate Officer |
Jun 16, 2025 | |
| Catherine Reaktenwalt |
Operational/Managerial Control | Oct 26, 2024 | |
| Adp of the SNF | Oct 26, 2024 | ||
| Central Peninsula General Hospital Inc |
5% Or Greater Direct Ownership Interest | Jul 1, 2006 | 100% |
| Adp of the SNF | Feb 3, 2026 | ||
| Trena Richardson |
Corporate Director |
Oct 1, 2009 | |
| Jay S Rohloff |
Corporate Director |
Jan 1, 2021 | |
| Jesse J Kincaid |
Corporate Director |
Jan 1, 2022 | |
| Shanda Rochelle Richards |
Operational/Managerial Control | Dec 14, 2020 | |
| Adp of the SNF | Dec 14, 2020 | ||
| Bradley T Cross |
Corporate Director |
Jan 1, 2023 | |
| Max Best |
Corporate Director | Jan 1, 2021 | |
| Stephanie Queen |
Corporate Director |
Jan 1, 2023 | |
| Angela Hinnegan |
Corporate Officer |
Jan 3, 2026 | |
| Barb Belloumini |
Corporate Director |
Jan 1, 2025 | |
| Silverio Mattero |
Corporate Director |
Jan 1, 2022 |
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Central Peninsula General Hospital |
Hospital | Operational/Managerial Control | Nov 26, 2007 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070109000068 | AK | Part a Provider - Skilled Nursing Facility | 4587552575 | Practice locations: Soldotna, AK |
National Provider Directory
- Tax ID family
- Cntrl Peninsula Gen Hos
- Part of
- Cntrl Peninsula Gen Hos
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | 736259 | AK | |
| Skilled Nursing Facility | 314000000X | 736259 | AK | Yes |
Addresses
Primary practice location
232 Rockwell
Soldotna, AK 99669
Mailing address
232 Rockwell
Soldotna, AK 99669
Phone (907) 262-2545
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LT0640 | Medicaid | AK |
Other names
- HERITAGE PLACE
Other providers in Soldotna, AK
- Central Peninsula General Hospital, Inc
- Central Peninsula General Hospital, Inc
- Central Peninsula General Hospital, Inc
- Central Peninsula General Hospital, Inc
- Central Peninsula General Hospital, Inc
- Central Peninsula General Hospital, Inc
- Central Peninsula Hospital
- Central Peninsula Hospital
- Certus Radiology, LLC
- David E Chambers
All providers in Soldotna, AK · Skilled Nursing Facility in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 26, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.