Foothills Behavioral Health

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

FOOTHILLS BEHAVIORAL HEALTH

Practice address

16635 Centerfield Dr Ste 204
Eagle River, AK 99577-7746

Phone

(907) 694-2300

Fax

(907) 694-2330

NPI assigned

Nov 9, 2021

Last updated

Nov 29, 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

Jason Martin, PMHNPNPI 1639507551

Title

Owner

Phone

(208) 360-0288

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Jason Martin, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Idaho Falls, ID
  • NPI 1639507551
  NPD Authorized official

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

{
    "created_epoch": "1636416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638144000000",
    "number": "1992461420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16635 CENTERFIELD DR STE 204",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777746",
            "telephone_number": "907-694-2300",
            "fax_number": "907-694-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16635 CENTERFIELD DR STE 204",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777746",
            "telephone_number": "907-694-2300",
            "fax_number": "907-694-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTHILLS BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-09",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-360-0288",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlin Fletcher, LMT
• Rudy Jerry Gilbert Florez
• Angela Floyd, LMT
• Amy Sue Foltz
• Rachel Fontano
• Kelly Forestal, BCBA-D
• Dale Forman
• Robin Forman
• Jenna S Forsyth, PSY.D
• Joanne K Fosdick, PTA

• Psychiatric/Mental Health Nurse Practitioner in Eagle River, AK
• Providers in Eagle River, AK by specialty
• Psychiatric/Mental Health Nurse Practitioner in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; 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.