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SOUTHCENTRAL FOUNDATION
NPI 1003469719
Community/Behavioral Health in Wasilla, AK

Active since July 22, 2019
1001 S KNIK GOOSE BAY RD, WASILLA, AK 99654(907) 631-7800 Get Directions Write a Review

NPPES record last updated: June 5, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 5, 2026, Aug 30, 2023, Jul 22, 2019 (3 updates tracked since 2019).

About Southcentral Foundation NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHCENTRAL FOUNDATION (NPI 1003469719), doing business as Bh 1115- Benteh Nuutah Primary Care Center, is a healthcare organization registered as a community/behavioral health in Wasilla, Alaska and active in the NPI registry since July 2019. The organization lists Ronald Lee Olson, Executive Vice President Of Finance, as its authorized official.

NPPES Registry Identity

NPI1003469719
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NameSOUTHCENTRAL FOUNDATION
Location Address1001 S KNIK GOOSE BAY RDWasilla, AK 99654-8083
Mailing AddressPo Box 35198Seattle, WA 98124-5198
Phone(907) 631-7800
Organization SubpartYes
Authorized OfficialRonald Lee OlsonExecutive Vice President Of Finance · (907) 729-4939
Enumeration DateJuly 22, 2019
Last NPPES UpdateJune 5, 20263 updates tracked since enumeration
NPPES CertifiedJune 5, 2026
✔ NPI 1003469719 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
1001 S KNIK GOOSE BAY RD, Wasilla, AK 99654
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Other Names 2

Doing Business AsBh 1115- Benteh Nuutah Primary Care Center
Doing Business AsSud/bh 1115- Vnpcc

Other Identifiers 1

Medicaid1696887AK

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Southcentral Foundation is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

457

Medicare enrollment records show 457 clinicians reassign Medicare billing to Southcentral Foundation, which bills Medicare for the services they deliver. Of these, 48 practice at this address and 58 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 24

Nurse Practitioner95
Mental Health Counselor50
Family Practice45
Pediatric Medicine42
Clinical Social Worker34
Psychiatry29
Obstetrics/Gynecology28
Physical Therapist in Private Practice28
16 other specialties106

Nearest to this location (20)

See all 457
Rebekah Bailey, LCSW
Clinical Social Worker
NPI 1245939354
1001 S KNIK GOOSE BAY RD
Wasilla, AK 99654
(907) 729-3300
✔ PECOS✔ Accepts MedicareSame address
Holli Blake, LCSW
Clinical Social Worker
NPI 1417518143
1001 S KNIK GOOSE BAY RD
Wasilla, AK 99654
(907) 631-7800
✔ PECOSSame address
Lara Church, MD
Family Practice
NPI 1043280449
1001 S KNIK GOOSE BAY RD
Wasilla, AK 99654
(907) 631-7800
✔ PECOS✔ Accepts MedicareSame address
Laurie Dahms, M.D.
Family Practice
NPI 1245285964
1001 S KNIK GOOSE BAY RD
Wasilla, AK 99654
(907) 631-7800
✔ PECOS✔ Accepts MedicareSame address
Shawn Darnell, LPC-S, CDC I, MAC
Mental Health Counselor
NPI 1598002206
1001 S KNIK GOOSE BAY RD
Wasilla, AK 99654
(907) 297-8881
✔ PECOS✔ Accepts MedicareSame address
Melissa Dawley, MSN, APRN, FNP-C
Nurse Practitioner
NPI 1386008340
1001 S KNIK GOOSE BAY RD
Wasilla, AK 99654
(907) 631-7800
✔ PECOS✔ Accepts MedicareSame address
Jessica Depweg, LPC
Mental Health Counselor
NPI 1861066573
1001 S KNIK GOOSE BAY RD
Wasilla, AK 99654
(907) 631-7342
✔ PECOSSame address
Tarah Desatoff, OD
Optometry
NPI 1497317168
1001 S KNIK GOOSE BAY RD
Wasilla, AK 99654
(907) 631-7640
✔ PECOS✔ Accepts MedicareSame address
Jacob Eby, M.D.
Pediatric Medicine
NPI 1295112159
1001 S KNIK GOOSE BAY RD
Wasilla, AK 99654
(907) 729-3300
✔ PECOSSame address
Andrea Farmer, APRN
Nurse Practitioner
NPI 1588141741
1001 S KNIK GOOSE BAY RD
Wasilla, AK 99654
(907) 631-7800
✔ PECOS✔ Accepts MedicareSame address
Ema Fiedler, RDN
Registered Dietitian or Nutrition Professional
NPI 1023944865
1001 S KNIK GOOSE BAY RD
Wasilla, AK 99654
(907) 631-7800
Same address
John Forbes, M.D.
Psychiatry
NPI 1942296694
1001 S KNIK GOOSE BAY RD
Wasilla, AK 99654
(907) 631-7800
✔ PECOSSame address
Heather Hamilton, CNM
Certified Nurse Midwife (CNM)
NPI 1154947570
1001 S KNIK GOOSE BAY RD
Wasilla, AK 99654
(907) 631-7800
✔ PECOSSame address
Allison Hillen, MS, RDN
Registered Dietitian or Nutrition Professional
NPI 1356964662
1001 S KNIK GOOSE BAY RD
Wasilla, AK 99654
(907) 631-7800
Same address
Angel Husher, OD
Optometry
NPI 1548693831
1001 S KNIK GOOSE BAY RD
Wasilla, AK 99654
(907) 631-7800
✔ PECOS✔ Accepts MedicareSame address
Jeremy Jensen, MD
Psychiatry
NPI 1346322500
1001 S KNIK GOOSE BAY RD
Wasilla, AK 99654
(907) 631-7800
✔ PECOSSame address
Susan Steffans, D.O.
Osteopathic Manipulative Medicine
NPI 1326298175
1001 S KNIK GOOSE BAY RD
Wasilla, AK 99654
(907) 631-7803
✔ PECOS✔ Accepts MedicareSame address
Adam Tudor, D.C.
Chiropractic
NPI 1881084754
1001 S KNIK GOOSE BAY RD
Wasilla, AK 99654
(907) 631-7630
✔ Accepts MedicareSame address
Shannon Walker, CNM
Certified Nurse Midwife (CNM)
NPI 1679029953
1001 S KNIK GOOSE BAY RD
Wasilla, AK 99654
(907) 631-7800
✔ PECOS✔ Accepts MedicareSame address
William Freeman, DPT
Physical Therapist in Private Practice
NPI 1104997881
1001 S KNIK GOOSE BAY RD
Wasilla, AK 99654
(907) 729-7280
✔ Accepts MedicareSame address
See all 457 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southcentral Foundation's NPI number?

The NPI number for Southcentral Foundation is 1003469719. It was assigned to this organization in the NPPES registry on July 22, 2019. The provider is doing business as BH 1115- Benteh Nuutah Primary Care Center and Sud/Bh 1115- Vnpcc.

Where is Southcentral Foundation located?

Southcentral Foundation is located at 1001 S Knik Goose Bay Rd, Wasilla, AK 99654. The listed phone number is (907) 631-7800.

What is Southcentral Foundation's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

Is Southcentral Foundation enrolled in Medicare?

Yes. Southcentral Foundation is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Southcentral Foundation?

According to the CMS Revalidation Reassignment List (October 2026 release), 457 clinicians in 24 Medicare specialties reassign their Medicare billing to Southcentral Foundation. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (95), Mental Health Counselor (50) and Family Practice (45). Of these, 48 practice at this address and 58 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Southcentral Foundation accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list Southcentral Foundation as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Southcentral Foundation was last updated on June 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.