SOUTHCENTRAL FOUNDATION (NPI# 1528600947) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528600947 |
| Entity Type | Organization |
| Organization Name | SOUTHCENTRAL FOUNDATION |
| Practice Address |
6901 E Tudor Rd Ste 8 Anchorage AK 99507-1254 |
| Mailing Address |
Po Box 35198 Seattle WA 98124-5198 |
| Practice Telephone | 9077296500 |
| Practice Fax Number | 9077298607 |
| Mailing Telephone | 9077295418 |
| Mailing Fax Number | 9077298607 |
| Enumeration Date | 2019-10-17 |
| Last Update Date | 2019-10-17 |
| Authorized Official Name | RONALD LEE OLSON (VP OF FINANCE) |
| Authorized Official Telephone | 7017294939 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Elders Program 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 |
| 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 |
| 1639537640 | Southcentral Foundation | Clinic/Center | 1 Flight Line Road, Port Alsworth, AK 99653 | 2016-02-04 |
| Street Address |
6901 E TUDOR RD STE 8 |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99507-1254 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124634233 | Mackena Elsie Johnson | Massage Therapist | Sports & Spinal Injury Clinic, 6634 Lake Otis Pkwy #a, Anchorage, AK 99507 | 2020-09-23 |
| 1710599808 | Abracadabra Speech LLC | Speech-Language Pathologist | 6823 Tudor Road, Anchorage, AK 99507 | 2020-08-19 |
| 1487111241 | Fe Comon | Nursing Home Administrator | 1841 E 57th Ave., 1841 E 57th Ave., Anchorage, AK 99507 | 2019-02-27 |
| 1780171249 | Carol Won | Pharmacist | 2550 E. 88th Ave., Anchorage, AK 99507 | 2018-04-19 |
| 1821549411 | Isioma Nwaeme | Registered Nurse | 2529 Rives Court, Anchorage, AK 99507 | 2016-10-18 |
| 1669921268 | Michaelyn Scott | Massage Therapist | 1601 E. Dimond Blvd., Suite 201, Anchorage, AK 99507 | 2016-09-25 |
| 1013387638 | Robert R Croley | Case Manager/Care Coordinator | 1515 E Tudor Rd Ste 6, Anchorage, AK 99507 | 2015-09-25 |
| 1124494265 | Ryan Scott Fordt | Chiropractor | 2665 E Tudor Rd Ste 201, Anchorage, AK 99507 | 2015-08-12 |
| 1073907465 | Sarah E Lawrence | Case Manager/Care Coordinator | 1750 Abbott Road, Alzheimer's Resource of Alaska, Anchorage, AK 99507 | 2015-03-24 |
| 1699184507 | Melissa Lingad | Nurse's Aide | 7691 Winchester St., Anchorage, AK 99507 | 2014-08-05 |
| Find all providers in zip 99507 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487265690 | Whole Family Integrated Wellness LLC | Clinic/Center | 600 E 36th Ave Ste 300, Anchorage, AK 99503-4168 | 2020-08-11 |
| 1811420391 | Southcentral Foundation | Clinic/Center | 1021 E 3rd Ave, Anchorage, AK 99501-6102 | 2017-04-11 |
| 1689021776 | Southcentral Foundation | Clinic/Center | 755 A St, Anchorage, AK 99501-3625 | 2016-05-18 |
| 1154591451 | La Integrative Primary Care Centre Inc | Clinic/Center | 8811 Toloff St, Anchorage, AK 99507-3848 | 2008-03-03 |
| 1720603095 | Southcentral Foundation | Clinic/Center | 4441 Diplomacy Dr, Anchorage, AK 99508-5910 | 2020-06-12 |
| 1124666730 | Southcentral Foundation | Clinic/Center | 4441 Diplomacy Dr, Anchorage, AK 99508-5910 | 2019-12-13 |
| 1174027296 | Southcentral Foundation | Clinic/Center | 4441 Diplomacy Dr, Anchorage, AK 99508-5910 | 2018-03-22 |
| 1407360977 | Full Spectrum Health, LLC | Clinic/Center | 307 E Northern Lights Blvd Ste 201, Anchorage, AK 99503-2701 | 2017-11-20 |
| 1194130823 | Peak Neurology and Sleep Medicine, LLC | Clinic/Center | 2741 Debarr Rd Ste C308, Anchorage, AK 99508 | 2014-06-20 |
| 1659581635 | Alaska Center for Pediatrics, LLC | Clinic/Center | 2925 Debarr Rd, Suite 230, Anchorage, AK 99508-2959 | 2007-05-22 |
| 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.