CENTRAL PENINSULA GENERAL HOSPITAL, INC (NPI# 1174122766) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174122766 |
| Entity Type | Organization |
| Organization Name | CENTRAL PENINSULA GENERAL HOSPITAL, INC |
| Practice Address |
47480 Kristina Way Kenai AK 99611-5902 |
| Mailing Address |
250 Hospital Pl Soldotna AK 99669-7559 |
| Practice Telephone | 9077144521 |
| Mailing Telephone | 9077144502 |
| Mailing Fax Number | 9077144696 |
| Enumeration Date | 2020-10-23 |
| Last Update Date | 2020-10-23 |
| Authorized Official Name | RICHARD LANE DAVIS (CEO) |
| Authorized Official Telephone | 9077144723 |
| Is Organization Subpart | Y |
| Parent Organization Name | CENTRAL PENINSULA GENERAL HOSPITAL, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Other Name | Type Code |
|---|---|
| Serenity House Treatment Facility | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588207179 | Central Peninsula General Hospital, Inc | Clinic/Center | 10128 Kenai Spur Hwy, Kenai, AK 99611-7807 | 2019-10-25 |
| 1073043717 | Central Peninsula General Hospital, Inc | Community/Behavioral Health | 354 Tyee St, Soldotna, AK 99669-7657 | 2017-06-15 |
| 1922036060 | Central Peninsula General Hospital, Inc | Nursing Facility/Intermediate Care Facility | 232 Rockwell, Soldotna, AK 99669 | 2006-06-29 |
| 1538631478 | Central Peninsula General Hospital, Inc | Family Medicine | 245 N Binkley St Ste 202, Soldotna, AK 99669-7500 | 2018-12-17 |
| 1639523418 | Central Peninsula General Hospital, Inc | Internal Medicine | 108 E Corral Ave, Soldotna, AK 99669-7524 | 2016-04-19 |
| 1003299108 | Central Peninsula General Hospital, Inc | General Acute Care Hospital | 805 Frontage Rd, Suite 123, Kenai, AK 99611-9104 | 2015-07-07 |
| 1275948424 | Central Peninsula General Hospital, Inc | General Acute Care Hospital | 240 Hospital Pl, Ste 303a, Soldotna, AK 99669-7559 | 2014-06-26 |
| 1780099051 | Central Peninsula General Hospital, Inc | General Acute Care Hospital | 240 Hospital Pl, Ste 203, Soldotna, AK 99669-7559 | 2014-06-25 |
| 1245411453 | Central Peninsula General Hospital, Inc | Durable Medical Equipment & Medical Supplies | 250 Hospital Place, Soldotna, AK 99669 | 2007-11-15 |
| Street Address |
47480 KRISTINA WAY |
| City | KENAI |
| State | AK |
| Zip Code | 99611-5902 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245892744 | Christy Lynn Walker | Counselor | 47480 Kristina Way, Kenai, AK 99611-5902 | 2019-07-03 |
| 1720689607 | Heidi Wynne King | Counselor | 47480 Kristina Way, Kenai, AK 99611-5902 | 2020-11-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649803099 | Guardian Flight LLC | Ambulance | 145 Granite Point Ct, Kenai, AK 99611 | 2020-02-13 |
| 1104482967 | James Daniel Hudson | Massage Therapist | 601 Frontage Rd Suite 103, Kenai, AK 99611 | 2019-05-16 |
| 1255996351 | Shelly Lynn Niblack | Counselor | 10200, Kenai Sour Hwy, Kenai, AK 99611 | 2019-05-03 |
| 1780142042 | Odyssey Family Practice LLC | Clinic/Center | 11595 Kenai Spur Highway, Kenai, AK 99611 | 2019-03-06 |
| 1043793656 | Jerri Ann Chivers | Massage Therapist | 10815 Kenai Spur Highway, Kenai, AK 99611 | 2018-09-10 |
| 1003320060 | Christine G. Morin | Massage Therapist | 1608 Tanga Circle, Kenai, AK 99611 | 2017-11-28 |
| 1013433259 | Amanda Mckinley | Registered Nurse | 630 Barnacle Way Suite A, Kenai, AK 99611 | 2017-08-18 |
| 1780132753 | Kenai Peninsula Imaging Center LLC | Clinic/Center | 100 Trading Bay Rd Ste 7, Kenai, AK 99611 | 2016-09-19 |
| 1376905000 | Savana Long | Licensed Practical Nurse | 1700 Cone Avenue, Kenai, AK 99611 | 2016-03-22 |
| 1477977684 | Jac Enterprises, Inc. | Assisted Living Facility | 701 North Forest Dr, Kenai, AK 99611 | 2014-02-07 |
| Find all providers in zip 99611 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346791746 | Akeela Inc | Community/Behavioral Health | 805 Frontage Rd Ste 200b, Kenai, AK 99611-9122 | 2016-10-20 |
| 1174171417 | Cook Inlet Council On Alcohol and Drug Abuse | Community/Behavioral Health | 10200 Kenai Spur Hwy, Kenai, AK 99611-7807 | 2019-08-29 |
| 1699986687 | Kenaitze Indian Tribe | Community/Behavioral Health | 110 N Willow St, Kenai, AK 99611-7701 | 2007-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700483781 | Anchorage Community Mental Health Services, Inc | Community/Behavioral Health | 704 W 26th Ave, Anchorage, AK 99503-2532 | 2020-10-03 |
| 1992314215 | Residential Youth Care, Inc. | Community/Behavioral Health | 2442 Tongass Avenue, Ketchikan, AK 99901 | 2020-07-23 |
| 1124646641 | Alaska Art Therapy and Counseling | Community/Behavioral Health | 1107 W 8th St Unit 5, Juneau, AK 99801-1853 | 2020-07-10 |
| 1316563026 | Residential Youth Care, Inc. | Community/Behavioral Health | 606 Hill Road, Ketchikan, AK 99901 | 2020-06-18 |
| 1043836851 | Residential Youth Care, Inc. | Community/Behavioral Health | 2514 1st Avenue, Ketchikan, AK 99901 | 2020-06-18 |
| 1215553029 | Residential Youth Care, Inc. | Community/Behavioral Health | 2951 Baranof Avenue, Ketchikan, AK 99901 | 2020-06-18 |
| 1316561509 | Juneau Youth Services, Inc. | Community/Behavioral Health | 1507 3rd St, Douglas, AK 99824 | 2020-06-03 |
| 1225652407 | Juneau Youth Services, Inc. | Community/Behavioral Health | 1600 Renninger St, Juneau, AK 99801 | 2020-06-03 |
| 1316561590 | Juneau Youth Services, Inc. | Community/Behavioral Health | 2901 Riverside Dr, Juneau, AK 99801 | 2020-06-03 |
| 1366066540 | Juneau Youth Services, Inc. | Community/Behavioral Health | 3400 Tongass Blvd, Juneau, AK 99801 | 2020-06-03 |
| 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.