SOUTHCENTRAL FOUNDATION (NPI# 1396913570) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396913570 |
| Entity Type | Organization |
| Organization Name | SOUTHCENTRAL FOUNDATION |
| Other Organization Name | TRIBAL TARGETED CASE MANAGEMENT CLINIC |
| Practice Address |
4201 Tudor Centre Dr Suite 315 Anchorage AK 99508-5904 |
| Mailing Address |
4201 Tudor Centre Dr Suite 320 Anchorage AK 99508-5904 |
| Practice Telephone | 9077294907 |
| Mailing Telephone | 9077298624 |
| Mailing Fax Number | 9077298607 |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2010-09-01 |
| Authorized Official Name | DAVID A MORGAN (DIRECTOR OF REIMBURSEMENT) |
| Authorized Official Telephone | 9077294955 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 171M00000X | Case Manager/Care Coordinator | 20467 | AK | Other Service Providers |
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Other Name | Type Code |
|---|---|
| Tribal Targeted Case Management 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 |
4201 TUDOR CENTRE DR SUITE 315 |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99508-5904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568435113 | Ronald A Feigin | Psychiatry & Neurology | 4201 Tudor Centre Dr, Suite 303, Anchorage, AK 99508-5904 | 2006-02-13 |
| 1497397541 | Sandra Cherise Cummings | Physical Therapy Assistant | 4201 Tudor Centre Dr, Anchorage, AK 99508-5914 | 2019-10-10 |
| 1578114922 | Allison Schreck | Physical Therapy Assistant | 4201 Tudor Centre Dr, Anchorage, AK 99508-5914 | 2019-09-26 |
| 1629629142 | Sherilyn Soots | Physical Therapy Assistant | 4201 Tudor Centre Dr, Anchorage, AK 99508-5914 | 2019-09-25 |
| 1639653561 | Monica Gallagher | Massage Therapist | 4201 Tudor Centre Dr, Anchorage, AK 99508-5914 | 2018-09-17 |
| 1871025262 | Wendy Olsen | Massage Therapist | 4201 Tudor Centre Dr, Third Floor, Anchorage, AK 99508-5914 | 2017-04-03 |
| 1790192433 | Southcentral Foundation | Clinic/Center | 4201 Tudor Centre Dr, Anchorage, AK 99508-5914 | 2014-07-15 |
| 1184964199 | Christinejoy Cunanan Bilbao | Physical Therapy Assistant | 4201 Tudor Centre Dr, Anchorage, AK 99508-5904 | 2013-02-28 |
| 1174889828 | Kelly Anne Campbell | Social Worker | 4201 Tudor Centre Dr, Suite #300, Anchorage, AK 99508-5904 | 2012-04-06 |
| 1841594827 | Southcentral Foundation | Dietary Manager | 4201 Tudor Centre Dr, Attn: Diabetes Education, Anchorage, AK 99508-5904 | 2011-01-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366063349 | Alexandra L Davis | Student in an Organized Health Care Education/Training Program | 1202 E 36th Ave, Anchorage, AK 99508 | 2020-05-01 |
| 1366087108 | The Salvation Army, A California Corporation | Community/Behavioral Health | 3600 East 20th Avenue, Anchorage, AK 99508 | 2019-11-15 |
| 1679120349 | Kila Gilcart | Speech-Language Pathologist | 161 Klevin Street #103, Anchorage, AK 99508 | 2019-08-19 |
| 1326692963 | Shannon Maillet | Behavior Technician | 1650 S Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1427602044 | Frank Harris Lawson Iv | Behavior Technician | 1650 S. Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1104470723 | Vivalesi Seforosa Nair | Behavior Technician | 1650 South Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1043864267 | The Cozy Chalet Assisted Living Home LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3707 Mt Blanc Circle, Anchorage, AK 99508 | 2019-07-25 |
| 1942861778 | Christine Mary Hoover | Registered Nurse | Alaska Native Medical Center - Inpatient Pediatrics, 4315 Diplomacy Dr, Anchorage, AK 99508 | 2019-06-24 |
| 1215594502 | Ashley Ongtowasruk | Case Manager/Care Coordinator | 4441 Dipomacy Dr, Suite 500, Anchorage, AK 99508 | 2019-05-22 |
| 1659937019 | Rayne Johnson | Behavior Technician | 4000 San Ernesto Blvd, Anchorage, AK 99508 | 2019-05-11 |
| Find all providers in zip 99508 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710597679 | Holly Reynoso | Case Manager/Care Coordinator | 14232 Snowdrift Way, Anchorage, AK 99515-4165 | 2020-08-05 |
| 1588272157 | Far North Care Coordination Agency | Case Manager/Care Coordinator | 2230 Sentry Dr Apt B308, Anchorage, AK 99507-4688 | 2020-07-20 |
| 1518581834 | Eric Edward Villasenor | Case Manager/Care Coordinator | 1515 E Tudor Rd Ste 9a, Anchorage, AK 99507-1036 | 2020-06-02 |
| 1982225934 | Rebecca Cho | Case Manager/Care Coordinator | 7556 Tarsus Dr, Anchorage, AK 99502-1888 | 2020-04-30 |
| 1396365086 | Kaleidoscope Care Coordination LLC | Case Manager/Care Coordinator | 6534 Mulberry Dr, Anchorage, AK 99502-2160 | 2020-04-22 |
| 1982232856 | Galina B Turnipseed | Case Manager/Care Coordinator | 1515 E Tudor Rd Ste 9, Anchorage, AK 99507-1036 | 2020-03-27 |
| 1407496862 | Anchorage Care Coordination, LLC | Case Manager/Care Coordinator | 11761 Spyglass Cir, Anchorage, AK 99515-2706 | 2020-01-13 |
| 1073157897 | Thelma Desjarlais | Case Manager/Care Coordinator | 9201 Shorecrest Drive, Anchorage, AK 99502 | 2019-11-05 |
| 1194366070 | Sean Alyston Sullivan | Case Manager/Care Coordinator | 1645 Mountainman Loop, Anchorage, AK 99507-1975 | 2019-10-02 |
| 1164072088 | Carolyn Palembas | Case Manager/Care Coordinator | 1905 E 4th Ave, Anchorage, AK 99501-2908 | 2019-09-12 |
| Find all providers in ANCHORAGE | ||||
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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.