STATE OF ALASKA PUBLIC HEALTH NURSING (NPI# 1346601457) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346601457 |
| Entity Type | Organization |
| Organization Name | STATE OF ALASKA PUBLIC HEALTH NURSING |
| Other Organization Name | STATE OF ALASKA |
| Practice Address |
3054 Fifth Ave Ketchikan AK 99901-5773 |
| Mailing Address |
14818 N Tongass Hwy Ketchikan AK 99901-8902 |
| Practice Telephone | 9072254350 |
| Practice Fax Number | 9072470978 |
| Mailing Telephone | 9072254328 |
| Enumeration Date | 2016-03-16 |
| Last Update Date | 2016-03-16 |
| Authorized Official Name | MRS. SUSAN RENEE BERGMANN (NURSE MANAGER) |
| Authorized Official Telephone | 9072254350 |
| Authorized Official Credential | RN |
| Is Organization Subpart | Y |
| Parent Organization Name | STATE OF ALASKA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | NURR8365 | AK | Agencies |
| Other Name | Type Code |
|---|---|
| State of Alaska | Other Name - Individual/Organization |
| Street Address |
3054 FIFTH AVE |
| City | KETCHIKAN |
| State | AK |
| Zip Code | 99901-5773 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104219666 | Susan Newburn-medel | Registered Nurse | 3054 Fifth Ave, Ketchikan, AK 99901-5773 | 2015-03-09 |
| 1386099265 | Joann Shimek | Registered Nurse | 3054 Fifth Ave, Ketchikan, AK 99901-5773 | 2016-04-28 |
| 1508227612 | Kathryn Helfrich | Registered Nurse | 3054 Fifth Ave, Ketchikan, AK 99901-5773 | 2016-03-16 |
| 1518331834 | Jennifer Lynn Bergen | Registered Nurse | 3054 Fifth Ave, Ketchikan, AK 99901-5773 | 2015-11-24 |
| 1770977738 | Tonda Wolfe | Registered Nurse | 3054 Fifth Ave, Ketchikan, AK 99901-5773 | 2015-03-26 |
| 1497148753 | Emily Mcclory | Registered Nurse | 3054 Fifth Ave, Ketchikan, AK 99901-5773 | 2015-03-11 |
| 1619360948 | Leanne Waak | Registered Nurse | 3054 Fifth Ave, Ketchikan, AK 99901-5773 | 2015-03-11 |
| 1699168054 | Angel Holbrook | Nurse's Aide | 3054 Fifth Ave, Ketchikan, AK 99901-5773 | 2015-03-10 |
| 1285027755 | Evan Phillips | Registered Nurse | 3054 Fifth Ave, Ketchikan, AK 99901-5773 | 2015-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992314215 | Residential Youth Care, Inc. | Community/Behavioral Health | 2442 Tongass Avenue, Ketchikan, AK 99901 | 2020-07-23 |
| 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 |
| 1174159222 | Helene Rae Simpson | Behavior Technician | 201 Deermont St, Ketchikan, AK 99901 | 2020-03-20 |
| 1003295155 | Suzanne Webb | Massage Therapist | 602 Dock St Ste 106, Ketchikan, AK 99901 | 2015-05-22 |
| 1093194342 | Kate Mortensen | Case Manager/Care Coordinator | 2690 Tongass Ave, Ketchikan, AK 99901 | 2015-05-20 |
| 1578879631 | Thomas Peter Ryan | Social Worker | 320 Bawden St. #318, Ketchikan, AK 99901 | 2010-08-27 |
| 1689820979 | Akeela Inc | Community Based Residential Treatment Facility, Mental Illness | 3050 Fifth Ave, Ketchikan, AK 99901 | 2008-08-18 |
| 1750565438 | Susan Marie Swift | Nurse Practitioner | 21 Jefferson Way, Suite 202, Psychiatry, Ketchikan, AK 99901 | 2007-12-18 |
| Find all providers in zip 99901 | ||||
| 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 |
|---|---|---|---|---|
| 1992314215 | Residential Youth Care, Inc. | Community/Behavioral Health | 2442 Tongass Avenue, Ketchikan, AK 99901 | 2020-07-23 |
| 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 |
| 1073766317 | Kic/thc Behavioral Health Department | Community/Behavioral Health | 2960 Tongass Ave Fl 1, Ketchikan, AK 99901-5742 | 2008-10-30 |
| 1568061232 | Community Connections | Community/Behavioral Health | 721 Stedman St, Ketchikan, AK 99901-6632 | 2020-10-22 |
| 1336771781 | Residential Youth Care, Inc. | Community/Behavioral Health | 2524 1st Avenue, Ketchikan, AK 99901 | 2020-02-04 |
| 1669010922 | Akeela Inc | Community/Behavioral Health | 3050 Fifth Ave, Ketchikan, AK 99901-5773 | 2019-12-18 |
| 1588834154 | Ketchikan Indian Community | Community/Behavioral Health | 2960 Tongass Ave, Ketchikan, AK 99901-5742 | 2008-03-10 |
| 1346423415 | Community Connections | Community/Behavioral Health | 201 Deermount St, Ketchikan, AK 99901-6649 | 2007-12-12 |
| Find all providers in KETCHIKAN | ||||
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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.