NPIMap

Organization Active NPI

Central Peninsula General Hospital, Inc

  • MOHS-Micrographic Surgery Physician
  • Soldotna, AK
National Provider Identifier
1972429892
Registry record updated Oct 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
Legal business name
CENTRAL PENINSULA GENERAL HOSPITAL, INC
Practice address
254 N Binkley St
Soldotna, AK 99669-7522
Phone
(907) 714-5930
NPI assigned
Jun 25, 2026
Last updated
Oct 9, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
CENTRAL PENINSULA GENERAL HOSPITAL, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 9, 2026

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

Authorized official

Name
Shanda Richards
Title
Associate Cfo
Phone
(907) 714-4502

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X NU Primary

Addresses

Primary practice location

254 N Binkley St
Soldotna, AK 99669-7522

Mailing address

250 Hospital PL
Soldotna, AK 99669-7559
Phone (907) 714-4575

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cc_acp_dermatology_front_desk_pool12226840@ak.providencedirect.org Direct

National Provider Directory

National Provider Directory
Tax ID family
Central Peninsula G Hos18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Locations

254 N Binkley St
Soldotna, AK 99669
Phone (907) 260-2622

NPI Registry JSON

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

{
    "created_epoch": "1782345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791504000000",
    "number": "1972429892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 HOSPITAL PL",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697559",
            "telephone_number": "907-714-4575",
            "fax_number": "907-262-5191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 N BINKLEY ST",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697522",
            "telephone_number": "907-714-5930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL PENINSULA GENERAL HOSPITAL, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRAL PENINSULA GENERAL HOSPITAL, INC",
        "enumeration_date": "2026-06-25",
        "last_updated": "2026-10-09",
        "certification_date": "2026-10-09",
        "status": "A",
        "authorized_official_last_name": "RICHARDS",
        "authorized_official_first_name": "SHANDA",
        "authorized_official_title_or_position": "ASSOCIATE CFO",
        "authorized_official_telephone_number": "907-714-4502"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cc_acp_dermatology_front_desk_pool12226840@ak.providencedirect.org",
            "affiliation": "N",
            "endpointDescription": "CPH Dermatology Clinic Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "254 N Binkley St",
            "city": "Soldotna",
            "state": "AK",
            "country_code": "US",
            "postal_code": "996697522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Soldotna, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.