SOUTHCENTRAL FOUNDATION (NPI# 1689194250) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689194250 |
| Entity Type | Organization |
| Organization Name | SOUTHCENTRAL FOUNDATION |
| Practice Address |
1001 S Knik Goose Bay Rd Wasilla AK 99654-8083 |
| Mailing Address |
4501 Diplomacy Dr Anchorage AK 99508-5919 |
| Practice Telephone | 9077298624 |
| Mailing Telephone | 9077298624 |
| Enumeration Date | 2017-06-23 |
| Last Update Date | 2017-06-23 |
| Authorized Official Name | RONALD LEE OLSON (VP OF FINANCE) |
| Authorized Official Telephone | 9077298624 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 20467 | AK | Dietary & Nutritional Service Providers |
| 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 |
1001 S KNIK GOOSE BAY RD |
| City | WASILLA |
| State | AK |
| Zip Code | 99654-8083 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245285964 | Laurie Elizabeth Dahms | Family Medicine | 1001 S Knik Goose Bay Rd, Wasilla, AK 99654-8083 | 2006-05-23 |
| 1154947570 | Heather Hamilton | Advanced Practice Midwife | 1001 S Knik Goose Bay Rd, Wasilla, AK 99654-8083 | 2020-06-22 |
| 1356964662 | Allison Michelle Hillen | Dietitian, Registered | 1001 S Knik Goose Bay Rd, Wasilla, AK 99654-8083 | 2020-05-20 |
| 1619526381 | Emily K Wood | Counselor | 1001 S Knik Goose Bay Rd, Wasilla, AK 99654-8083 | 2019-09-05 |
| 1114573284 | Emily Marie Schmitt | Nurse Practitioner | 1001 S Knik Goose Bay Rd, Wasilla, AK 99654-8083 | 2019-08-14 |
| 1225683709 | Jolie Miller | Registered Nurse | 1001 S Knik Goose Bay Rd, Wasilla, AK 99654-8083 | 2019-08-01 |
| 1003469719 | Southcentral Foundation | Community/Behavioral Health | 1001 S Knik Goose Bay Rd, Wasilla, AK 99654-8083 | 2019-07-22 |
| 1497317168 | Tarah Ruth Desatoff | Optometrist | 1001 S Knik Goose Bay Rd, Wasilla, AK 99654-8083 | 2019-07-02 |
| 1417518143 | Holli Blake | Social Worker | 1001 S Knik Goose Bay Rd, Wasilla, AK 99654-8083 | 2019-06-24 |
| 1831755560 | Kathy Bowman | Case Manager/Care Coordinator | 1001 S Knik Goose Bay Rd, Wasilla, AK 99654-8083 | 2019-05-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003426784 | Colleen Maggie Newcity | Case Manager/Care Coordinator | 851 Westpoint Suite 310, Wasilla, AK 99654 | 2020-08-06 |
| 1659995884 | Amy M Lowe | Peer Specialist | 1363 W Spuce Ave, Wasilla, AK 99654 | 2020-06-03 |
| 1922648690 | Achieve Medical Alaska LLC | Clinic/Center | 1981 E Palmer, Suite 230, Wasilla, AK 99654 | 2020-01-10 |
| 1588205538 | Juan Carlos Garcia | Physician Assistant | 950 East Bogard Road, Suite 103, Wasilla, AK 99654 | 2019-10-01 |
| 1427610864 | Sharon Webb | Counselor | 705 S Knik Goose Bay Rd Suite K, Wasilla, AK 99654 | 2019-07-06 |
| 1306401864 | Logan Lee Cook | Peer Specialist | 2953 E Fairview Loop, Wasilla, AK 99654 | 2019-05-09 |
| 1053883595 | Moose Creek Medical Clinic LLC | Nurse Practitioner | 2341 S. Fern St., Suite 300, Wasilla, AK 99654 | 2018-12-21 |
| 1487124962 | Melissa A Stevens | Massage Therapist | 2201 W That Rd, Wasilla, AK 99654 | 2018-11-28 |
| 1609359561 | Audrey E Beers | Midwife | 2405 S. Knik Goose Bay Rd., Wasilla, AK 99654 | 2018-09-07 |
| 1093297418 | Karlee Janine Mccorry | Occupational Therapist | 613 S Knik-goose Bay Rd, Wasilla, AK 99654 | 2018-09-01 |
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| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528594694 | Ashley Buchanan | Dietitian, Registered | 1001 Knik Goose Bay Road, Wasilla, AK 99654 | 2017-05-10 |
| 1356964662 | Allison Michelle Hillen | Dietitian, Registered | 1001 S Knik Goose Bay Rd, Wasilla, AK 99654-8083 | 2020-05-20 |
| 1750889234 | Southcentral Foundation | Dietitian, Registered | 1001 S Knik Goose Bay Rd, Wasilla, AK 99654-8083 | 2018-01-30 |
| 1841721164 | Kylie Jane Viens | Dietitian, Registered | 1001 S Knik Goose Bay Rd, Wasilla, AK 99654-8083 | 2017-03-27 |
| 1497165963 | Alesya Oleynik | Dietitian, Registered | 1001 S Knik Goose Bay Rd, Wasilla, AK 99654-8083 | 2014-05-05 |
| 1497900278 | Rebecca J. Moore | Dietitian, Registered | 950 E Bogard Rd, Suite 207, Wasilla, AK 99654-7184 | 2008-11-20 |
| 1265607360 | Laura Phillips | Dietitian, Registered | 2000 E Industrial Dr, Wasilla, AK 99654-8201 | 2008-04-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124631759 | Britta Amber Brecheen | Dietitian, Registered | 3403 Lois Dr, Anchorage, AK 99517-2000 | 2020-08-24 |
| 1518579473 | Soleil Thiele | Dietitian, Registered | 2210 N Broadway Dr, Palmer, AK 99645-9316 | 2020-08-20 |
| 1619593449 | Audrey Conrad | Dietitian, Registered | 16924 Foothill Ave Apt 3, Eagle River, AK 99577-8298 | 2020-06-17 |
| 1952934895 | Lea Palmer | Dietitian, Registered | 22835 Glacier View Dr, Eagle River, AK 99577-9560 | 2020-02-19 |
| 1457919227 | Janne Holmberg Maier | Dietitian, Registered | 250 Cushman St Ste 3h, Fairbanks, AK 99701-4665 | 2019-06-05 |
| 1326506866 | Balance and Nourish | Dietitian, Registered | 25 Jefferson Way Ste 101b, Ketchikan, AK 99901-5953 | 2019-03-04 |
| 1396217261 | Angela Marie Colburn | Dietitian, Registered | 2751 Debarr Rd Ste 250, Anchorage, AK 99508-6818 | 2018-12-17 |
| 1730658493 | Emily Nicole Henry | Dietitian, Registered | 97 Eichner Ave, Ketchikan, AK 99901-9033 | 2018-11-24 |
| 1063997096 | Sabrina Kay Cabana | Dietitian, Registered | 7900 Evander Dr, Anchorage, AK 99518-3107 | 2018-09-25 |
| 1700381134 | Kimberly Leinani Wilcox | Dietitian, Registered | 621 W Dimond Blvd, Anchorage, AK 99515-1704 | 2018-03-27 |
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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.