NPIMap

Organization Active NPI

Bristol Bay Area Health Corp

  • Durable Medical Equipment & Medical Supplies
  • Dillingham, AK
National Provider Identifier
1942491220
Registry record updated Apr 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
BRISTOL BAY AREA HEALTH CORP
Practice address
6000 Kanakanak Rd
Dillingham, AK 99576
Phone
(907) 842-5201
Fax
(907) 842-9250
NPI assigned
Aug 5, 2007
Last updated
Apr 4, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2013

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

Authorized official

Name
Robert Clark
Title
Ceo
Phone
(907) 842-5201

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

6000 Kanakanak Rd
Dillingham, AK 99576

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
MS0067MedicaidAK

Other names 1

  • BBAHC DME Other name

Medicare participation

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

Enrollment records 1

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…

Other NPIs on the same Medicare enrollment 38

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

View all 38

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365033600000",
    "number": "1942491220",
    "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": "6000 KANAKANAK RD",
            "city": "DILLINGHAM",
            "state": "AK",
            "postal_code": "99576",
            "telephone_number": "907-842-5201",
            "fax_number": "907-842-9250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRISTOL BAY AREA HEALTH CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2013-04-04",
        "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"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MS0067",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BBAHC DME",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dillingham, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2013; 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.