NPIMap

Organization Active NPI

Petersburg Medical Center

  • Family Medicine Physician
  • Petersburg, AK
National Provider Identifier
1972666345
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PETERSBURG MEDICAL CENTER
Practice address
103 Fram Street
Petersburg, AK 99833-0589
Phone
(907) 772-4299
Fax
(907) 772-9273
NPI assigned
Dec 18, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. John Bringhurst
Title
Ceo
Phone
(907) 772-4291

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X AK Primary

Addresses

Primary practice location

103 Fram Street
Petersburg, AK 99833-0589

Mailing address

PO Box 589
Petersburg, AK 99833-0589
Phone (907) 772-4291

National Provider Directory

National Provider Directory
Tax ID family
The Petersburg Medical Center6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972666345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 589",
            "city": "PETERSBURG",
            "state": "AK",
            "postal_code": "998330589",
            "telephone_number": "907-772-4291",
            "fax_number": "907-772-3085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 FRAM STREET",
            "city": "PETERSBURG",
            "state": "AK",
            "postal_code": "998330589",
            "telephone_number": "907-772-4299",
            "fax_number": "907-772-9273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSBURG MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRINGHURST",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "907-772-4291",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petersburg, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.