SOUTHCENTRALFOUNDATION (NPI# 1669638227) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669638227 |
| Entity Type | Organization |
| Organization Name | SOUTHCENTRALFOUNDATION |
| Practice Address |
4320 Diplomacy Dr Anchorage AK 99508-5925 |
| Practice Telephone | 9077294955 |
| Mailing Telephone | 9077294955 |
| Enumeration Date | 2008-08-04 |
| Last Update Date | 2008-08-04 |
| Authorized Official Name | DR. DOUGLAS EBY (VICE PRSIDENT MEDICAL SERVICES) |
| Authorized Official Telephone | 9077294955 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
10662 | AK | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | STATE OF ALASKA REGISTERED NURSE | 10662 | 01 |
| Street Address |
4320 DIPLOMACY DR |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99508-5925 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275536104 | Cynthia Aguiar | Pharmacist | 4320 Diplomacy Dr, Anchorage, AK 99508-5925 | 2005-05-24 |
| 1164023594 | Stacie Ann Williamson | Counselor | 4320 Diplomacy Dr, Anchorage, AK 99508-5925 | 2020-11-03 |
| 1235739590 | Tiffany Ma | Pharmacist | 4320 Diplomacy Dr, Anchorage, AK 99508-5925 | 2020-10-27 |
| 1124627922 | Southcentral Foundation | Pharmacy | 4320 Diplomacy Dr, Anchorage, AK 99508-5925 | 2020-10-22 |
| 1689281834 | Jessica Anahy Martinez | Counselor | 4320 Diplomacy Dr, Anchorage, AK 99508-5925 | 2020-09-30 |
| 1801400494 | Ariel Nicole Moilanen | Counselor | 4320 Diplomacy Dr, Anchorage, AK 99508-5925 | 2020-09-01 |
| 1407466386 | Timothy Lee Griffin | Counselor | 4320 Diplomacy Dr, Anchorage, AK 99508-5925 | 2020-08-05 |
| 1073122065 | Kobe Keo Liftee Thammavongsa | Registered Nurse | 4320 Diplomacy Dr, Anchorage, AK 99508-5925 | 2020-07-27 |
| 1225653041 | Destiny Steward | Behavior Technician | 4320 Diplomacy Dr, Anchorage, AK 99508-5925 | 2020-06-09 |
| 1003430240 | Edward Washington II | Counselor | 4320 Diplomacy Dr, Anchorage, AK 99508-5925 | 2020-06-03 |
| 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 | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295361228 | Akins Mobile Health & Clinical Consultants, LLC | Clinic/Center | 2942 Gladys Marie Cir, Anchorage, AK 99516-1407 | 2020-03-22 |
| 1457865271 | Vera Whole Health Inc | Clinic/Center | 1450 Muldoon Rd, Anchorage, AK 99504-2820 | 2017-12-01 |
| 1780079749 | John D. Zipperer Jr Md, LLC | Clinic/Center | 2110 E. Northern Lights Blvd., Suite 102, Anchorage, AK 99508 | 2015-04-06 |
| 1609173798 | M. Jane Moore, Md. LLC. | Clinic/Center | 3260 Providence Dr Ste 526, Anchorage, AK 99508-4608 | 2011-02-25 |
| 1821304379 | Manuka Health Clinic, LLC | Clinic/Center | 3685 Arctic Blvd, Anchorage, AK 99503-5704 | 2010-08-23 |
| 1346400363 | House Calls 4 Kids, LLC | Clinic/Center | 4200 Yukla Cir, Anchorage, AK 99504-4739 | 2008-06-12 |
| 1114190824 | Surgery Assistants of Alaska LLC | Clinic/Center | 9150 Jewel Lake Road Ste B, Anchorage, AK 99502 | 2008-04-03 |
| 1437772886 | Southcentral Foundation | Clinic/Center | 4320 Diplomacy Dr, Anchorage, AK 99508-5925 | 2020-05-20 |
| 1558993451 | Access2care, LLC | Clinic/Center | 4120 Laurel St Ste 106, Anchorage, AK 99508-5392 | 2020-02-08 |
| 1205298957 | Primary Care Associates | Clinic/Center | 4100 Lake Otis Pkwy, Suite 322, Anchorage, AK 99508-5229 | 2016-03-22 |
| 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.