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SOUTHCENTRALFOUNDATION
NPI 1750052387
Clinic/Center - Multi-Specialty in Wasilla, AK

Active since September 23, 2021
3223 E PALMER WASILLA HWY STE 4, WASILLA, AK 99654(907) 729-6799(907) 729-8607 Get Directions Write a Review

NPPES record last updated: May 19, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: May 19, 2025, Sep 23, 2021 (2 updates tracked since 2021).

About Southcentralfoundation NPPES

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

SOUTHCENTRALFOUNDATION (NPI 1750052387), doing business as Tribal Benteh Nuutah Four Directions, is a healthcare organization registered as a multi-specialty in Wasilla, Alaska and active in the NPI registry since September 2021. The organization lists Jona Tetzloff, Manager, as its authorized official.

NPPES Registry Identity

NPI1750052387
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameSOUTHCENTRALFOUNDATION
Location Address3223 E PALMER WASILLA HWY STE 4Wasilla, AK 99654-7277
Mailing Address7033 E Tudor RdAnchorage, AK 99507-1262 · (907) 729-5083 · Fax (907) 729-5180
Phone(907) 729-6799
Fax(907) 729-8607
Organization SubpartNo
Authorized OfficialJona TetzloffManager · (907) 729-5083
Enumeration DateSeptember 23, 2021
Last NPPES UpdateMay 19, 20252 updates tracked since enumeration
NPPES CertifiedMay 19, 2025
✔ NPI 1750052387 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
3223 E PALMER WASILLA HWY STE 4, Wasilla, AK 99654
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Other Names 1

Doing Business AsTribal Benteh Nuutah Four Directions

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Southcentralfoundation 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 Southcentralfoundation, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 60 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
Martha Moore, MD-MPH
Addiction Medicine
NPI 1053418921
3223 E PALMER WASILLA HWY STE 4
Wasilla, AK 99654
(907) 631-6300
✔ PECOSSame address
Desiree Compton, LPC
Mental Health Counselor
NPI 1801137989
3223 E PALMER WASILLA HWY STE 4
Wasilla, AK 99654
(907) 631-6300
✔ PECOSSame address
Amanda Rose, LCSW
Clinical Social Worker
NPI 1134831357
3223 E PALMER WASILLA HWY STE 4
Wasilla, AK 99654
(907) 631-6300
✔ PECOS✔ Accepts MedicareSame address
Sarah Ferroni, FNP
Nurse Practitioner
NPI 1679081889
3190 E MERIDIAN PARK LOOP STE 206
Wasilla, AK 99654
(907) 373-2544
✔ PECOS0.4 mi
Katie Millican, SLP
Qualified Speech Language Pathologist
NPI 1871986745
3505 EAST MERIDIAN PARK LOOP, STE. 200
Wasilla, AK 99654
(907) 232-6322
0.6 mi
Troy Mcgill, MPT, PHD, SCS, DIP M
Physical Therapist in Private Practice
NPI 1083636088
3765 E BLUE LUPINE DR STE E
Wasilla, AK 99654
(907) 373-9462
✔ Accepts Medicare1.1 mi
Nicole Domaschuk-Jackson, PT, DPT
Physical Therapist in Private Practice
NPI 1346514718
1001 S KNIK GOOSE BAY RD
Wasilla, AK 99654
(907) 729-3300
✔ Accepts Medicare2.5 mi
Rebekah Bailey, LCSW
Clinical Social Worker
NPI 1245939354
1001 S KNIK GOOSE BAY RD
Wasilla, AK 99654
(907) 729-3300
✔ PECOS✔ Accepts Medicare2.6 mi
Holli Blake, LCSW
Clinical Social Worker
NPI 1417518143
1001 S KNIK GOOSE BAY RD
Wasilla, AK 99654
(907) 631-7800
✔ PECOS2.6 mi
Lara Church, MD
Family Practice
NPI 1043280449
1001 S KNIK GOOSE BAY RD
Wasilla, AK 99654
(907) 631-7800
✔ PECOS✔ Accepts Medicare2.6 mi
Laurie Dahms, M.D.
Family Practice
NPI 1245285964
1001 S KNIK GOOSE BAY RD
Wasilla, AK 99654
(907) 631-7800
✔ PECOS✔ Accepts Medicare2.6 mi
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 Medicare2.6 mi
Melissa Dawley, MSN, APRN, FNP-C
Nurse Practitioner
NPI 1386008340
1001 S KNIK GOOSE BAY RD
Wasilla, AK 99654
(907) 631-7800
✔ PECOS✔ Accepts Medicare2.6 mi
Tarah Desatoff, OD
Optometry
NPI 1497317168
1001 S KNIK GOOSE BAY RD
Wasilla, AK 99654
(907) 631-7640
✔ PECOS✔ Accepts Medicare2.6 mi
Jacob Eby, M.D.
Pediatric Medicine
NPI 1295112159
1001 S KNIK GOOSE BAY RD
Wasilla, AK 99654
(907) 729-3300
✔ PECOS2.6 mi
Ema Fiedler, RDN
Registered Dietitian or Nutrition Professional
NPI 1023944865
1001 S KNIK GOOSE BAY RD
Wasilla, AK 99654
(907) 631-7800
2.6 mi
John Forbes, M.D.
Psychiatry
NPI 1942296694
1001 S KNIK GOOSE BAY RD
Wasilla, AK 99654
(907) 631-7800
✔ PECOS2.6 mi
Heather Hamilton, CNM
Certified Nurse Midwife (CNM)
NPI 1154947570
1001 S KNIK GOOSE BAY RD
Wasilla, AK 99654
(907) 631-7800
✔ PECOS2.6 mi
Susan Steffans, D.O.
Osteopathic Manipulative Medicine
NPI 1326298175
1001 S KNIK GOOSE BAY RD
Wasilla, AK 99654
(907) 631-7803
✔ PECOS✔ Accepts Medicare2.6 mi
Adam Tudor, D.C.
Chiropractic
NPI 1881084754
1001 S KNIK GOOSE BAY RD
Wasilla, AK 99654
(907) 631-7630
✔ Accepts Medicare2.6 mi
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 Southcentralfoundation's NPI number?

The NPI number for Southcentralfoundation is 1750052387. It was assigned to this organization in the NPPES registry on September 23, 2021. The provider is doing business as Tribal Benteh Nuutah Four Directions.

Where is Southcentralfoundation located?

Southcentralfoundation is located at 3223 E Palmer Wasilla Hwy Ste 4, Wasilla, AK 99654. The listed phone number is (907) 729-6799.

What is Southcentralfoundation's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Is Southcentralfoundation enrolled in Medicare?

Yes. Southcentralfoundation is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Southcentralfoundation?

According to the CMS Revalidation Reassignment List (October 2026 release), 457 clinicians in 24 Medicare specialties reassign their Medicare billing to Southcentralfoundation. 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, 3 practice at this address and 60 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Southcentralfoundation was last updated on May 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.