PROVIDENCE HEALTH & SERVICES - WASHINGTON (NPI# 1376638171) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376638171 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES - WASHINGTON |
| Other Organization Name | PROVIDENCE EXTENDED CARE CENTER |
| Practice Address |
4900 Eagle St Anchorage AK 99503-7446 |
| Mailing Address |
Po Box 196276 Anchorage AK 99519-6276 |
| Practice Telephone | 9075622281 |
| Practice Fax Number | 9077620266 |
| Mailing Telephone | 9072126522 |
| Mailing Fax Number | 9072126593 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2012-01-31 |
| Authorized Official Name | MR. BRUCE LAMOUREUX (CEO) |
| Authorized Official Telephone | 9072125682 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | NOT NUMBERED | AK | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | MDG231 | 05 |
| Other Name | Type Code |
|---|---|
| PROVIDENCE EXTENDED CARE CENTER | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407162571 | Providence Health & Services - Washington | Internal Medicine | 510 E Amende Drive, Odessa, WA 99159-0000 | 2010-08-26 |
| 1841503034 | Providence Health & Services - Washington | Family Medicine | 18313 Paulsonst Sw, Suite A, Rochester, WA 98579-9262 | 2010-07-16 |
| 1083947709 | Providence Health & Services - Washington | Hospice Care, Community Based | 2731 Wetmore Ave Ste 500, Everett, WA 98201-3585 | 2009-09-14 |
| 1760636690 | Providence Health & Services - Washington | Neurological Surgery | 301 W Poplar Street, Ste 220, Walla Walla, WA 99362-2800 | 2008-11-05 |
| 1558512368 | Providence Health & Services - Washington | Home Health | 209 W Poplar St, Walla Walla, WA 99362 | 2008-10-10 |
| 1922259738 | Providence Health & Services - Washington | Internal Medicine | 380 Chase Avenue, Pmg Se Wa, Walla Walla, WA 99362-2924 | 2008-10-10 |
| 1306097126 | Providence Health & Services - Washington | Radiology | 401 W Poplar Street, Pmg Se Wa Imaging, Walla Walla, WA 99362-2846 | 2008-10-10 |
| 1043374119 | Providence Health & Services - Washington | Rehabilitation, Substance Use Disorder Unit | 508 Quarter Eighth Street, Hoquiam, WA 98550 | 2006-12-21 |
| 1073677605 | Providence Health & Services - Washington | Rehabilitation, Substance Use Disorder Unit | 506 W Franklin St, Shelton, WA 98584-3517 | 2006-12-20 |
| 1003906918 | Providence Health & Services - Washington | Home Health | 3432 Bay Rd Ne, Olympia, WA 98506-2958 | 2006-10-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Providence Health & Services - Washington | 1801 Lind Ave. Sw, #9016, Renton, WA 98057 |
| Street Address |
4900 EAGLE ST |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99503-7446 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215167382 | Providence Health and Services Alaska | Skilled Nursing Facility | 4900 Eagle St, Anchorage, AK 99503-7446 | 2009-07-22 |
| 1669652962 | John J. Smith | Family Medicine | 4900 Eagle St, Anchorage, AK 99503-7446 | 2007-11-05 |
| 1265561393 | Rita D Grenier | Pharmacist | 4900 Eagle St, Anchorage, AK 99503-7446 | 2007-03-05 |
| 1659407435 | Shirley Jean Evans | Pharmacist | 4900 Eagle St, Anchorage, AK 99503-7446 | 2007-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164020772 | Miladis Mcduffie | Massage Therapist | 1350 W. Northern Lights Blvd, Ste C, Anchorage, AK 99503 | 2020-10-15 |
| 1447804984 | Bethany Lynn Becker | Optometrist | 401 E. Northern Lights Blvd. Suite 102, Anchorage, AK 99503 | 2019-08-01 |
| 1265084933 | Carr-gottstein Foods Co | Durable Medical Equipment & Medical Supplies | 2920 Seward Hwy, Anchorage, AK 99503 | 2019-07-12 |
| 1982268942 | Rukiyia Smith | Behavior Technician | 205 E Northern Lights Blvd, Suite 110, Anchorage, AK 99503 | 2019-04-25 |
| 1245894310 | Mary Kathleen Tate | Specialist/Technologist | 205 E. Northern Lights Blvd, Suite 110, Anchorage, AK 99503 | 2019-04-24 |
| 1194295766 | Kimberly Sue Trent | Registered Nurse | 670 W. Fireweed Lane Suite 160, Anchorage, AK 99503 | 2018-11-27 |
| 1659869089 | Alaska Spine & Pain Center, LLC | Chiropractor | 3901 Old Seward Hwy Ste 11, Anchorage, AK 99503 | 2018-05-01 |
| 1235643123 | Rosanne Louise Klouda | Massage Therapist | 213 Fireweed Ln, Anchorage, AK 99503 | 2017-11-30 |
| 1801309042 | Online Care Group Alaska | General Practice | 200 W. 34th Ave, Anchorage, AK 99503 | 2017-11-09 |
| 1548773849 | Leslie K Michalski | Massage Therapist | 510 W Tudor Rd Ste 9, Anchorage, AK 99503 | 2017-11-08 |
| Find all providers in zip 99503 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780866715 | Raindance Healthcare Group, Inc. | Skilled Nursing Facility | 3510 Spenard Rd Ste 100, Anchorage, AK 99503-3777 | 2007-11-30 |
| 1124025507 | Providence Health & Services Washington | Skilled Nursing Facility | 910 Compassion Circle, Anchorage, AK 99504-1645 | 2005-06-30 |
| 1396096996 | Providence Health & Services - Washington | Skilled Nursing Facility | 3760 Piper St, Suite 1061, Anchorage, AK 99508-4683 | 2012-09-24 |
| 1215167382 | Providence Health and Services Alaska | Skilled Nursing Facility | 4900 Eagle St, Anchorage, AK 99503-7446 | 2009-07-22 |
| 1801021290 | Care Center Anchorage Inc. | Skilled Nursing Facility | 9100 Centennial Cir, Anchorage, AK 99504-1480 | 2009-05-28 |
| 1285729087 | Providence Health System - Washington | Skilled Nursing Facility | 9100 Centennial Cir, Anchorage, AK 99504-1480 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548814718 | Maple Springs of Palmer Snf Holdings, LLC | Skilled Nursing Facility | 12130 E Maple Springs Way, Palmer, AK 99645 | 2019-07-26 |
| 1821438342 | Yukon-kuskokwim Health Corporation | Skilled Nursing Facility | 1100 Chief Eddie Hoffman Hwy, Bethel, AK 99559 | 2013-06-28 |
| 1518240084 | Maniilaq Association | Skilled Nursing Facility | 436 Mission St, Kotzebue, AK 99752-0510 | 2011-09-21 |
| 1821102757 | City of Seward | Skilled Nursing Facility | 2203 Oak Street, Seward, AK 99664 | 2006-08-18 |
| 1790715928 | City of Valdez | Skilled Nursing Facility | 911 Meals Avenue, Valdez, AK 99686 | 2006-07-04 |
| 1821036880 | Denali Center | Skilled Nursing Facility | 1510 19th Ave, Fairbanks, AK 99701-5900 | 2006-06-03 |
| 1255302386 | Wildflower Court Inc | Skilled Nursing Facility | 2000 Salmon Creek Ln, Juneau, AK 99801-7801 | 2006-01-27 |
| 1356901961 | Southeast Alaska Regional Health Consortium | Skilled Nursing Facility | 209 Moller Ave, Sitka, AK 99835-7142 | 2019-06-17 |
| 1396223210 | Southeast Alaska Regional Health Consortium | Skilled Nursing Facility | 310 Bennett St, Wrangell, AK 99929 | 2018-08-02 |
| 1326597410 | Denali Center, LLC | Skilled Nursing Facility | 1510 19th Ave, Fairbanks, AK 99701-5900 | 2016-09-29 |
| 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.