SOUTH PENINSULA HOSPITAL, INC.
NPI 1679566269
General Acute Care Hospital - Critical Access in Homer, AK
NPI Status: Active since August 29, 2005
Contact Information
4300 BARTLETT STREET
HOMER, AK
ZIP 99603
Phone: (907) 235-8101
Fax: (907) 235-0253
- Organization
- General Acute Care Hospital
- Critical Access
- Accepts Insurance
- CLIA Number: 02D0663791
- CLIA Cert. Type: Hospital
- CLIA Exp. Date: 05-28-2027
About SOUTH PENINSULA HOSPITAL, INC.
This page provides the complete NPI Profile along with additional information for South Peninsula Hospital, Inc., a provider established in Homer, Alaska operating as a General Acute Care Hospital, focusing in critical access . The healthcare provider is registered in the NPI registry with number 1679566269 assigned on August 2005. The practitioner's primary taxonomy code is 282NC0060X. The provider is registered as an organization and their NPI record was last updated 6 years ago. South Peninsula Hospital, Inc. operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Mr. Ryan Smith (Chief Executive Officer)
- NPI
- 1679566269
- Provider Name
- SOUTH PENINSULA HOSPITAL, INC.
- Entity Type
- Organization
- Location Address
- 4300 BARTLETT STREET HOMER, AK 99603
- Location Phone
- (907) 235-8101
- Location Fax
- (907) 235-0253
- Mailing Address
- 4300 BARTLETT STREET HOMER, AK 99603
- Mailing Phone
- (907) 235-8101
- Mailing Fax
- (907) 235-0253
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-29-2005
- Last Update Date
- 02-07-2020
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
General Acute Care Hospital Critical Access
- Taxonomy Code
- 282NC0060X
- Type
- Hospitals
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207PE0004X | Allopathic & Osteopathic Physicians | Emergency Medicine | |
| 2 | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | |
| 3 | 208600000X | Allopathic & Osteopathic Physicians | Surgery | |
| 4 | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Moda Select Alaska Bronze 6500 - PPO
- Moda Select Alaska Bronze HDHP 5500 - PPO
- Moda Select Alaska Gold 1500 - PPO
- Moda Select Alaska Silver 4500 - PPO
- Moda Select Alaska Standard Bronze - PPO
- Moda Select Alaska Standard Gold - PPO
- Moda Select Alaska Standard Silver - PPO
- Moda Select Texas Bronze 8700 ($0 Virtual Urgent Care through CirrusMD) - EPO
- Moda Select Texas Bronze HDHP 7500 - EPO
- Moda Select Texas Standard Bronze - EPO
- Moda Select Texas Standard Gold - EPO
- Moda Select Texas Standard Silver - EPO
- Premera Blue Cross Alaska One Gold - PPO
- Premera Blue Cross Preferred Bronze 5800 HSA - PPO
- Premera Blue Cross Preferred Bronze 6350 - PPO
- Premera Blue Cross Preferred Gold 1500 - PPO
- Premera Blue Cross Preferred Silver 4500 - PPO
- Premera Blue Cross Standard Bronze II - PPO
- Premera Blue Cross Standard Gold - PPO
- Premera Blue Cross Standard Silver - PPO
- Premera Blue Cross Family Dental - PPO
- Premera Blue Cross Pediatric Dental - PPO
- HSA Qualified 7500 Bronze - Choice Network - EPO
- HSA-E Qualified 7500 Bronze - Signature Network - EPO
- Providence Oregon Standard Bronze Plan - Choice Network - EPO
- Providence Oregon Standard Bronze Plan - Signature Network - EPO
- Providence Oregon Standard Gold Plan - Choice Network - EPO
- Providence Oregon Standard Gold Plan - Signature Network - EPO
- Providence Oregon Standard Silver Plan - Choice Network - EPO
- Providence Oregon Standard Silver Plan - Signature Network - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1005654 | MEDICAID (05) | AK | |
| 1028527 | MEDICAID (05) | AK | |
| 1582637 | MEDICAID (05) | AK | |
| 1005653 | MEDICAID (05) | AK | |
| 1005186 | MEDICAID (05) | AK | |
| 1020634 | MEDICAID (05) | AK | |
| 1701931 | MEDICAID (05) | AK | |
| 1582664 | MEDICAID (05) | AK | |
| 1687518 | MEDICAID (05) | AK | |
| 1687514 | MEDICAID (05) | AK |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 02D0663791
- Facility Type
- Hospital
- Certificate Effective Date
- May 29, 2025
- Certificate Expiration Date
- May 28, 2027
- Laboratory Director
- DR. MICHAEL S. CLARKE
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to South Peninsula Hospital, Inc. after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1679566269, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 61 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 4 providers are registered at the same or a nearby location.
HOMER, AK 99603
HOMER, AK 99603
HOMER, AK 99603
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1679566269, enumerated as an "organization" on August 29, 2005.
The provider is located at 4300 BARTLETT STREET HOMER, AK 99603 and the phone number is (907) 235-8101.
General Acute Care Hospital with taxonomy code 282NC0060X and a focus in Critical Access.
The provider might be accepting Accepts: Moda Health Plan, Inc., Premera Blue Cross Blue. Please consult your insurance carrier or call the provider to verify.
