CENTRAL PENINSULA GENERAL HOSPITAL, INC (NPI# 1538631478) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538631478 |
| Entity Type | Organization |
| Organization Name | CENTRAL PENINSULA GENERAL HOSPITAL, INC |
| Practice Address |
245 N Binkley St Ste 202 Soldotna AK 99669-7500 |
| Mailing Address |
250 Hospital Pl Soldotna AK 99669-7559 |
| Practice Telephone | 9077144521 |
| Practice Fax Number | 9072604063 |
| Mailing Telephone | 9077144521 |
| Mailing Fax Number | 9072604063 |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2018-12-17 |
| 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 | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Serenity House Medical Clinic | 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 |
| 1174122766 | Central Peninsula General Hospital, Inc | Community/Behavioral Health | 47480 Kristina Way, Kenai, AK 99611-5902 | 2020-10-23 |
| 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 |
245 N BINKLEY ST STE 202 |
| City | SOLDOTNA |
| State | AK |
| Zip Code | 99669-7500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245203918 | Kristie Kay Sellers | Psychologist | 245 N Binkley St Ste 202, Soldotna, AK 99669-7500 | 2006-02-10 |
| 1568061265 | Jodi Lynn Lout | Counselor | 245 N Binkley St Ste 202, Soldotna, AK 99669-7500 | 2020-10-22 |
| 1992312748 | Christie B Gibbs | Community Health Worker | 245 N Binkley St Ste 202, Soldotna, AK 99669-7500 | 2020-09-25 |
| 1790391142 | Amy Margaret Wunnicke | Counselor | 245 N Binkley St Ste 202, Soldotna, AK 99669-7500 | 2020-09-21 |
| 1225690555 | Krista Rae Collinson | Counselor | 245 N Binkley St Ste 202, Soldotna, AK 99669-7500 | 2019-07-08 |
| 1134781461 | Brett James Toering | Counselor | 245 N Binkley St Ste 202, Soldotna, AK 99669-7500 | 2019-07-08 |
| 1770145922 | Jody Jo Asimakopoulos | Counselor | 245 N Binkley St Ste 202, Soldotna, AK 99669-7500 | 2019-07-08 |
| 1841858693 | Maghan Kruzick | Counselor | 245 N Binkley St Ste 202, Soldotna, AK 99669-7500 | 2019-06-05 |
| 1437717063 | Jennifer Fay Showalter Yeoman | Social Worker | 245 N Binkley St Ste 202, Soldotna, AK 99669-7500 | 2019-05-29 |
| 1598322307 | Shari Le Bryant-conner | Counselor | 245 N Binkley St Ste 202, Soldotna, AK 99669-7500 | 2019-05-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881201226 | Kyle Arron Shassetz | Counselor | 43335 K-beach Rd., Soldotna, AK 99669 | 2020-09-29 |
| 1720614993 | Peninsula Instacare | Clinic/Center | 34581 Kenai Spur Hwy, Suite 1, Soldotna, AK 99669 | 2020-03-19 |
| 1871141077 | Alaine Viola Lagasse | Counselor | Kenai Vet Center, 43299 Kalifornsky Beach Road Ste 4, Soldotna, AK 99669 | 2019-08-30 |
| 1962970574 | Ryder R Storm | Behavior Technician | 338800 Community College Drive, Suite 1, Soldotna, AK 99669 | 2018-11-13 |
| 1356821540 | Tanecia Webster | Nurse Practitioner | 36570 Kenai Spur Hwy, Ste 103a, Soldotna, AK 99669 | 2018-08-16 |
| 1821519869 | Theresa Napolitano | Case Manager/Care Coordinator | 35477 Kenai Spur Hwy Suite 203, Soldotna, AK 99669 | 2017-06-29 |
| 1689048282 | Jeanne Bignell | Licensed Practical Nurse | 35020 Alaskan View Lane, Soldotna, AK 99669 | 2015-11-19 |
| 1952786105 | Ian Charles Mcmullen | Pharmacist | 44001 Sterling Highway, Soldotna, AK 99669 | 2015-07-29 |
| 1841679933 | Lana Clymer | Case Manager/Care Coordinator | 22994 Kalifornsky Beach Rd, Soldotna, AK 99669 | 2015-05-22 |
| 1861800773 | Phillip Bruce | Physical Therapy Assistant | 35105 Kenai Spury Hwy, Suite A, Soldotna, AK 99669 | 2014-07-24 |
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| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790133239 | Louis Bartoletti | Family Medicine | 245 N Binkley St Ste 101, Soldotna, AK 99669-7500 | 2016-05-25 |
| 1114332855 | Christina Marie Turknett | Family Medicine | 206 W Rockwell Ave Ste 100, Soldotna, AK 99669-7439 | 2014-06-20 |
| 1982894861 | Kristen Marie Iagulli Lee | Family Medicine | 245 N Binkley St Ste 103, Soldotna, AK 99669-7500 | 2007-07-27 |
| 1578660528 | Tara D Lathrop | Family Medicine | 230 E. Marydale Ave, Suite 1, Soldotna, AK 99669-2949 | 2006-09-20 |
| 1992814818 | Katy Sheridan Md PC | Family Medicine | 154 W Marydale Ave, Soldotna, AK 99669-7501 | 2006-08-30 |
| 1154334381 | Lavern R Davidhizar | Family Medicine | 206 W Rockwell Ave, Suite 100, Soldotna, AK 99669-7411 | 2006-08-15 |
| 1518983246 | Katy Marie Sheridan | Family Medicine | 245 N Binkley St Ste 203, Soldotna, AK 99669-7500 | 2006-07-14 |
| 1467436071 | Gladys Bailon | Family Medicine | 161 N Binkley St, Suite 101, Soldotna, AK 99669-7521 | 2005-12-06 |
| 1598757312 | Marguerite Mcintosh | Family Medicine | 230 E Marydale, Suite 1, Soldotna, AK 99669-7636 | 2005-08-17 |
| 1700403235 | Abigail Jorgensen | Family Medicine | 230 E Marydale Ave, Soldotna, AK 99669-7648 | 2020-06-30 |
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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.