SOUTHCENTRAL FOUNDATION (NPI# 1487121331) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487121331 |
| Entity Type | Organization |
| Organization Name | SOUTHCENTRAL FOUNDATION |
| Practice Address |
26341 Eklutna Village Rd Chugiak AK 99567-5148 |
| Mailing Address |
Po Box 35151 Seattle WA 98124-5151 |
| Practice Telephone | 9073176070 |
| Practice Fax Number | 8179774688 |
| Mailing Telephone | 9073176070 |
| Mailing Fax Number | 8179774688 |
| Enumeration Date | 2018-10-30 |
| Last Update Date | 2018-10-30 |
| Authorized Official Name | KATHRYN SUZANNE MILLER (PATIENT ACCOUNTS MANAGER- DENTAL) |
| Authorized Official Telephone | 9073176070 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers | ||
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Eklutna Dental Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407466204 | Southcentral Foundation | Clinic/Center | 11495 N Callison St, Sutton, AK 99674 | 2020-08-06 |
| 1528600947 | Southcentral Foundation | Clinic/Center | 6901 E Tudor Rd Ste 8, Anchorage, AK 99507-1254 | 2019-10-17 |
| 1639722069 | Southcentral Foundation | Community/Behavioral Health | 4175 Tudor Centre Dr, Anchorage, AK 99508-5917 | 2019-07-24 |
| 1659924025 | Southcentral Foundation | Community/Behavioral Health | 4341 Tudor Centre Dr Ste 300, Anchorage, AK 99508-5904 | 2019-07-24 |
| 1720548035 | Southcentral Foundation | Clinic/Center | 4441 Diplomacy Dr Fl 5, Anchorage, AK 99508-5910 | 2019-03-22 |
| 1750854089 | Southcentral Foundation | Clinic/Center | 400 W Benson Blvd, Anchorage, AK 99503-3829 | 2019-01-09 |
| 1639652662 | Southcentral Foundation | Clinic/Center | 26341 Eklutna Village Rd, Chugiak, AK 99567-5148 | 2018-09-14 |
| 1811420391 | Southcentral Foundation | Clinic/Center | 1021 E 3rd Ave, Anchorage, AK 99501-6102 | 2017-04-11 |
| 1043767940 | Southcentral Foundation | Dentist | 11495 N. Callison Street, Sutton, AK 99674 | 2016-09-08 |
| 1689021776 | Southcentral Foundation | Clinic/Center | 755 A St, Anchorage, AK 99501-3625 | 2016-05-18 |
| Street Address |
26341 EKLUTNA VILLAGE RD |
| City | CHUGIAK |
| State | AK |
| Zip Code | 99567-5148 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639652662 | Southcentral Foundation | Clinic/Center | 26341 Eklutna Village Rd, Chugiak, AK 99567-5148 | 2018-09-14 |
| 1144830837 | Southcentral Foundation | Community/Behavioral Health | 26341 Eklutna Village Rd, Chugiak, AK 99567-5148 | 2020-08-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326552217 | Lilian Alison Crites-flesher | Massage Therapist | 21944 Rankin Rd, Chugiak, AK 99567 | 2017-11-30 |
| 1457886368 | Deborah Joyce Forcht | Nurse Practitioner | 22525 Ursa Major Circle, Chugiak, AK 99567 | 2017-04-28 |
| 1871976662 | Aurora Advocacy LLC | Case Management | 19991 Tulwar Drive, Chugiak, AK 99567 | 2015-06-30 |
| 1497028526 | Phillip D. Courtney | Contractor | 18708 Sue Tawn Drive, Chugiak, AK 99567 | 2012-02-21 |
| 1265717540 | Aurora Borealis Assisted Living Home LLC | Assisted Living Facility | 22179 North Birchwood Loop, Chugiak, AK 99567 | 2011-10-18 |
| 1114184181 | Cs Wellness, LLC | Chiropractor | 20775 Old Glenn Highway, Chugiak, AK 99567 | 2008-05-19 |
| 1295909588 | Patricia Ann Morgan | Speech-Language Pathologist | 18618 Amonson Road, Chugiak, AK 99567 | 2008-04-17 |
| 1053505917 | Chugiak Volunteer Fire & Rescue Inc | Ambulance | 17214 Old Glenn Hwy, Chugiak, AK 99567 | 2007-09-04 |
| 1902020290 | Lorraine Fullbright | Case Manager/Care Coordinator | 18606 Old Glenn Highway, Chugiak, AK 99567 | 2007-04-11 |
| 1235273343 | Kirby W Holtman | Chiropractor | 20963 Bill Stephens Dr., Chugiak, AK 99567 | 2007-02-20 |
| Find all providers in zip 99567 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962011593 | Deyoung Dentistry, LLC | Clinic/Center | 2601 Boniface Parkway Suite 1, Anchorage, AK 99504 | 2020-07-29 |
| 1205461084 | Hawkinson Dental Inc | Clinic/Center | 6200 Lake Otis Pkwy Ste 101, Anchorage, AK 99507-2098 | 2020-03-11 |
| 1982238622 | Donald R Mclean | Clinic/Center | 3719 E Meridian Loop Ste B, Wasilla, AK 99654-7273 | 2020-03-02 |
| 1740745439 | Susan Olson Dmd Inc | Clinic/Center | 3261 S. Big Lake Rd. Ste D3-d4, Big Lake, AK 99652 | 2019-02-06 |
| 1932664877 | Alaska Family Dental LLC | Clinic/Center | 405 W 36th Ave Ste 101, Anchorage, AK 99503-5872 | 2019-02-05 |
| 1174016737 | Lake Road Dental LLC | Clinic/Center | 4622 Shannon Lake Rd, Dillingham, AK 99576 | 2018-06-08 |
| 1659862134 | Evelyn Haley Dmd | Clinic/Center | 615 E 82nd Ave Ste 100, Anchorage, AK 99518-3100 | 2018-05-21 |
| 1891285433 | Alaskan Family Dental Center LLC | Clinic/Center | 281 N Main St Ste 201, Wasilla, AK 99654-7046 | 2018-05-17 |
| 1376051797 | Caroline Curtis Dmd PC | Clinic/Center | 16635 Centerfield Dr Ste 207, Eagle River, AK 99577-7746 | 2018-01-19 |
| 1417475716 | Michael G. Crookston Dds PC | Clinic/Center | 11723 Old Glenn Hwy Ste 207, Eagle River, AK 99577-7750 | 2017-09-07 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SOUTHCENTRAL FOUNDATION.
| 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.