SOUTH PENINSULA HOSPITAL, INC (NPI# 1164400750) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164400750 |
| Entity Type | Organization |
| Organization Name | SOUTH PENINSULA HOSPITAL, INC |
| Practice Address |
203 W Pioneer Ave Homer AK 99603-7527 |
| Mailing Address |
4300 Bartlett St Homer AK 99603-7005 |
| Practice Telephone | 9072350369 |
| Practice Fax Number | 9072350810 |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2020-02-07 |
| Authorized Official Name | RYAN SMITH (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 9072350241 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | HH2711 | AK | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | 1002677 | 05 | |
| AK | 1021539 | 05 | |
| AK | 1005186 | 05 | |
| AK | 1022057 | 05 | |
| AK | 1004606 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093968372 | South Peninsula Hospital, Inc | Medicare Defined Swing Bed Unit | 4300 Bartlett St, Homer, AK 99603-7005 | 2008-10-30 |
| Street Address |
203 W PIONEER AVE |
| City | HOMER |
| State | AK |
| Zip Code | 99603-7527 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801175591 | Pamela Sue Hooker | Case Manager/Care Coordinator | 203 W Pioneer Ave, Homer, AK 99603-7527 | 2011-08-11 |
| 1821310962 | Ivy Lynn Betts | Registered Nurse | 203 W Pioneer Ave, Suite 1, Homer, AK 99603-7527 | 2010-02-16 |
| 1134452410 | Laurie Deakins | Case Manager/Care Coordinator | 203 W Pioneer Ave, Suite 1, Homer, AK 99603-7527 | 2009-09-17 |
| 1760491179 | M Todd Boling | Surgery | 203 W Pioneer Ave, Suite 2, Homer, AK 99603-7527 | 2006-08-05 |
| 1952310369 | Peninsula Surgical Clinic PC | Surgery | 203 W Pioneer Ave, Suite 2, Homer, AK 99603-7527 | 2006-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518572387 | Morgan Dwyer | Counselor | 51310 Timber Bay Ct, Homer, AK 99603 | 2020-09-09 |
| 1346859824 | John George Hetrick | Counselor | 51310 Timber Bay Ct., Homer, AK 99603 | 2020-07-30 |
| 1093352502 | Katieostrommd | Obstetrics & Gynecology | 205 W Fairview, Homer, AK 99603 | 2019-12-03 |
| 1023651965 | Melissa Elizabeth Malcolm | Physical Therapy Assistant | 4107 Hohe Ave, Homer, AK 99603 | 2019-10-23 |
| 1184143620 | Homer Birth and Wellness Center | Clinic/Center | 3902 Shelford Street, Homer, AK 99603 | 2017-09-15 |
| 1588913271 | Sharon Marie Gorman | Registered Nurse | 3959 Ben Walters, Homer, AK 99603 | 2012-09-10 |
| 1477802197 | Aldergrove Assisted Living | Community Based Residential Treatment Facility, Mental Illness | 41045 Denny Lane, Homer, AK 99603 | 2012-09-10 |
| 1194087551 | Stephen Michael Mueller | Pharmacist | 3858 Lake Street, Suite #5, Lakeside Mall, Homer, AK 99603 | 2012-06-12 |
| 1962778001 | Homer Dental Center Inc | Dentist | 4014 Lake St., Ste 210, Homer, AK 99603 | 2012-03-22 |
| 1346544368 | William R Easton | General Practice | 2495 Bayridge Rd, Homer, AK 99603 | 2011-01-05 |
| Find all providers in zip 99603 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295229524 | Vital Med Home Care Inc | Home Health | 1249 Historic Homer Hwy, Homer, GA 30547-2738 | 2018-06-20 |
| 1891089827 | L Woerner Inc | Home Health | 6 N West St, Suite 5, Homer, NY 13077-1049 | 2011-06-07 |
| 1649542051 | Care Options | Home Health | 1136 Seabreeze Ct, Homer, AK 99603-7935 | 2012-01-31 |
| 1518061522 | Homer Memorial Hospital | Home Health | 620 E College St, Homer, LA 71040-3202 | 2006-09-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417434150 | Shannon L Mckenzie | Home Health | 3913 Lynn Dr, Anchorage, AK 99508-5745 | 2018-07-25 |
| 1578065793 | Aderonke Akindipe Fnp LLC | Home Health | 2942 Gladys Marie Cir # Q, Anchorage, AK 99516-1407 | 2018-03-03 |
| 1952815706 | Southeast Alaska Regional Health Consortium | Home Health | 814 Halibut Point Rd Ste 202, Sitka, AK 99835-7101 | 2017-11-30 |
| 1609311430 | Shine Bright Care, LLC | Home Health | 6407 Brayton Dr Ste 100, Anchorage, AK 99507-2149 | 2017-01-03 |
| 1639521214 | Shine Bright Care | Home Health | 3007 Arctic Blvd Spc 2, Anchorage, AK 99503-3478 | 2016-07-07 |
| 1023493269 | Wellspring Home Health Center, LLC | Home Health | 201 E. Swanson Avenue, Suite 7, Wasilla, AK 99654 | 2015-07-29 |
| 1336540624 | Alaskan Home Health, Inc | Home Health | 9191 Old Seward Hwy Ste 19a, Anchorage, AK 99515-2040 | 2014-09-06 |
| 1992105787 | Immediate Care Inc. | Home Health | 4851 E Blue Lupine Dr, Suite B, Wasilla, AK 99654-8411 | 2014-08-28 |
| 1366865859 | Infinite Care of Alaska LLC | Home Health | 165 East 56th Ave., Suite #3, Anchorage, AK 99518 | 2014-02-04 |
| 1700207701 | Hearts & Hands of Care | Home Health | 1401 S Seward Meridian Pkwy, Suite A & B, Wasilla, AK 99654-8312 | 2013-12-18 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.