CENTRAL PENINSULA GENERAL HOSPITAL INC (NPI# 1770723967) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770723967 |
| Entity Type | Organization |
| Organization Name | CENTRAL PENINSULA GENERAL HOSPITAL INC |
| Other Organization Name | CENTRAL PENINSULA FAMILY PRACTICE |
| Practice Address |
506 Lake St Kenai AK 99611-6937 |
| Practice Telephone | 9077144030 |
| Practice Fax Number | 9073350064 |
| Mailing Telephone | 9077144030 |
| Mailing Fax Number | 9073350064 |
| Enumeration Date | 2009-02-27 |
| Last Update Date | 2017-01-12 |
| Authorized Official Name | RICHARD DAVIS (CEO) |
| Authorized Official Telephone | 9077144723 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
926294 | AK | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 926294 | AK | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 282NR1301X |
General Acute Care Hospital Specialization: Rural |
926294 | AK | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | BLUE CROSS | 155 | 01 |
| AK | TRICARE | 0004 | 01 |
| Other Name | Type Code |
|---|---|
| Central Peninsula Family Practice | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639494263 | Central Peninsula General Hospital Inc | General Acute Care Hospital | 240 Hospital Pl, Ste 204, Soldotna, AK 99669-7559 | 2010-04-07 |
| 1598063927 | Central Peninsula General Hospital Inc | General Acute Care Hospital | 240 Hospital Pl, Ste 305, Soldotna, AK 99669-7559 | 2011-03-09 |
| 1598063539 | Central Peninsula General Hospital Inc | General Acute Care Hospital | 108 E Corral Ave, Soldotna, AK 99669-7524 | 2011-02-28 |
| 1295059921 | Central Peninsula General Hospital Inc | General Acute Care Hospital | 245 N Binkley St, Suite 101, Soldotna, AK 99669-7523 | 2010-03-24 |
| 1992033153 | Central Peninsula General Hospital Inc | General Acute Care Hospital | 262 N Binkley St, Soldotna, AK 99669 | 2009-11-30 |
| Street Address |
506 LAKE ST |
| City | KENAI |
| State | AK |
| Zip Code | 99611-6937 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013902758 | Christine M Babcock | Nurse Practitioner | 506 Lake St, Kenai, AK 99611-6937 | 2005-09-19 |
| 1104951300 | Linda May Perry | Counselor | 506 Lake St, Kenai, AK 99611-6937 | 2007-02-21 |
| 1497809669 | Kevin Arthur Rullman | Family Medicine | 506 Lake St, Kenai, AK 99611-6937 | 2007-01-23 |
| 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 | 282NR1301X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Rural |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003299108 | Central Peninsula General Hospital, Inc | General Acute Care Hospital | 805 Frontage Rd, Suite 123, Kenai, AK 99611-9104 | 2015-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639494263 | Central Peninsula General Hospital Inc | General Acute Care Hospital | 240 Hospital Pl, Ste 204, Soldotna, AK 99669-7559 | 2010-04-07 |
| 1093043234 | Central Peninsula General Hospital | General Acute Care Hospital | 289 N Fireweed St, Suite C, Soldotna, AK 99669-7540 | 2009-11-30 |
| 1255585360 | Nshc Unalakleet Subregional Clinic | General Acute Care Hospital | 189 Happy Valley Rd, Unalakleet, AK 99684-0189 | 2008-11-17 |
| 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 |
| 1235480120 | Yukon Kuskokwim Health Corportation | General Acute Care Hospital | 700 Chief Eddie Hoffman Hwy, Ykhc Pharmacy Department, Bethel, AK 99559-0287 | 2012-10-02 |
| 1609143866 | Central Peninsula Hospital | General Acute Care Hospital | 250 Hospital Pl, Soldotna, AK 99669-7559 | 2011-11-16 |
| 1598063927 | Central Peninsula General Hospital Inc | General Acute Care Hospital | 240 Hospital Pl, Ste 305, Soldotna, AK 99669-7559 | 2011-03-09 |
| 1598063539 | Central Peninsula General Hospital Inc | General Acute Care Hospital | 108 E Corral Ave, Soldotna, AK 99669-7524 | 2011-02-28 |
| 1831404805 | Central Peninsula General Hospital | General Acute Care Hospital | 245 N Binkley St, Suite 101, Soldotna, AK 99669-7523 | 2010-08-13 |
| 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.