FAMILY MEDICAL CLINIC (NPI# 1073701421) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073701421 |
| Entity Type | Organization |
| Organization Name | FAMILY MEDICAL CLINIC |
| Other Organization Name | LAVERN DAVIDHIZAR |
| Practice Address |
206 W Rockwell Ave Suite 100 Soldotna AK 99669-7411 |
| Practice Telephone | 9072627566 |
| Practice Fax Number | 9072620809 |
| Mailing Telephone | 9072627566 |
| Mailing Fax Number | 9072620809 |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2012-10-29 |
| Authorized Official Name | DR. LAVERN R DAVIDHIZAR (PRESIDENT) |
| Authorized Official Telephone | 9072627566 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
4221 | AK | Allopathic & Osteopathic Physicians |
| N | 207L00000X | Anesthesiology | 4221 | AK | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 1454 | AK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | MD1454 | 05 |
| Other Name | Type Code |
|---|---|
| Lavern Davidhizar | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114139839 | Family Medical Clinic | Clinic/Center | 303 N East St # 2, Anaheim, CA 92805-3341 | 2007-05-04 |
| 1912126335 | Family Medical Clinic | Family Medicine | 110 W 1st St, Broken Bow, OK 74728-3902 | 2007-04-24 |
| 1639585466 | Family Medical Clinic | Internal Medicine | 4801 Palm Beach Blvd, Fort Myers, FL 33905-3214 | 2014-07-01 |
| 1295778074 | Family Medical Clinic | Family Medicine | 1405 E Kirk St, Suite B, Hugo, OK 74743-3603 | 2006-06-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | FAMILY MEDICAL CLINIC | 555 Prospect Ave Ste A, Estes Park, CO 80517-6347 |
| Virginia Business Entities | FAMILY MEDICAL CLINIC INC. | 10 Main St, Drakes Branch, Virginia 23937 |
| Washington State Corporations | FAMILY MEDICAL CLINIC INC. | 7909 Rainier Ave S, Seattle, WA 98118 |
| Street Address |
206 W ROCKWELL AVE SUITE 100 |
| City | SOLDOTNA |
| State | AK |
| Zip Code | 99669-7411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154334381 | Lavern R Davidhizar | Family Medicine | 206 W Rockwell Ave, Suite 100, Soldotna, AK 99669-7411 | 2006-08-15 |
| 1508300922 | Joanna Oliver Walls | Registered Nurse | 206 W Rockwell Ave, #100, Soldotna, AK 99669-7439 | 2016-12-05 |
| 1730459389 | Jolynn Montgomery | Physician Assistant | 206 W Rockwell Ave, Ste 100, Soldotna, AK 99669-7411 | 2012-01-12 |
| 1376791707 | Peninsula Neurology LLC | Psychiatry & Neurology | 206 W Rockwell Ave, Ste 100, Soldotna, AK 99669-7411 | 2008-08-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881201226 | Kyle Arron Shassetz | Counselor | 43335 K-beach Rd., Soldotna, AK 99669 | 2020-09-29 |
| 1720614993 | Peninsula Instacare | Clinic/Center | 34581 Kenai Spur Hwy, Suite 1, Soldotna, AK 99669 | 2020-03-19 |
| 1871141077 | Alaine Viola Lagasse | Counselor | Kenai Vet Center, 43299 Kalifornsky Beach Road Ste 4, Soldotna, AK 99669 | 2019-08-30 |
| 1962970574 | Ryder R Storm | Behavior Technician | 338800 Community College Drive, Suite 1, Soldotna, AK 99669 | 2018-11-13 |
| 1356821540 | Tanecia Webster | Nurse Practitioner | 36570 Kenai Spur Hwy, Ste 103a, Soldotna, AK 99669 | 2018-08-16 |
| 1821519869 | Theresa Napolitano | Case Manager/Care Coordinator | 35477 Kenai Spur Hwy Suite 203, Soldotna, AK 99669 | 2017-06-29 |
| 1689048282 | Jeanne Bignell | Licensed Practical Nurse | 35020 Alaskan View Lane, Soldotna, AK 99669 | 2015-11-19 |
| 1952786105 | Ian Charles Mcmullen | Pharmacist | 44001 Sterling Highway, Soldotna, AK 99669 | 2015-07-29 |
| 1841679933 | Lana Clymer | Case Manager/Care Coordinator | 22994 Kalifornsky Beach Rd, Soldotna, AK 99669 | 2015-05-22 |
| 1861800773 | Phillip Bruce | Physical Therapy Assistant | 35105 Kenai Spury Hwy, Suite A, Soldotna, AK 99669 | 2014-07-24 |
| Find all providers in zip 99669 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790133239 | Louis Bartoletti | Family Medicine | 245 N Binkley St Ste 101, Soldotna, AK 99669-7500 | 2016-05-25 |
| 1114332855 | Christina Marie Turknett | Family Medicine | 206 W Rockwell Ave Ste 100, Soldotna, AK 99669-7439 | 2014-06-20 |
| 1982894861 | Kristen Marie Iagulli Lee | Family Medicine | 245 N Binkley St Ste 103, Soldotna, AK 99669-7500 | 2007-07-27 |
| 1578660528 | Tara D Lathrop | Family Medicine | 230 E. Marydale Ave, Suite 1, Soldotna, AK 99669-2949 | 2006-09-20 |
| 1992814818 | Katy Sheridan Md PC | Family Medicine | 154 W Marydale Ave, Soldotna, AK 99669-7501 | 2006-08-30 |
| 1154334381 | Lavern R Davidhizar | Family Medicine | 206 W Rockwell Ave, Suite 100, Soldotna, AK 99669-7411 | 2006-08-15 |
| 1518983246 | Katy Marie Sheridan | Family Medicine | 245 N Binkley St Ste 203, Soldotna, AK 99669-7500 | 2006-07-14 |
| 1467436071 | Gladys Bailon | Family Medicine | 161 N Binkley St, Suite 101, Soldotna, AK 99669-7521 | 2005-12-06 |
| 1598757312 | Marguerite Mcintosh | Family Medicine | 230 E Marydale, Suite 1, Soldotna, AK 99669-7636 | 2005-08-17 |
| 1700403235 | Abigail Jorgensen | Family Medicine | 230 E Marydale Ave, Soldotna, AK 99669-7648 | 2020-06-30 |
| Find all providers in SOLDOTNA | ||||
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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.