RAVENWOOD HEALTHCARE LLC (NPI# 1205176245) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205176245 |
| Entity Type | Organization |
| Organization Name | RAVENWOOD HEALTHCARE LLC |
| Practice Address |
4200 Lake Otis Pkwy 202 Anchorage AK 99508-5226 |
| Practice Telephone | 9073382273 |
| Practice Fax Number | 9073382284 |
| Mailing Telephone | 9073382273 |
| Mailing Fax Number | 9073382284 |
| Enumeration Date | 2013-02-28 |
| Last Update Date | 2013-02-28 |
| Authorized Official Name | CHRISTY SLATER (MANAGING MEMBER) |
| Authorized Official Telephone | 9073382273 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
1111 | AK | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4200 LAKE OTIS PKWY 202 |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99508-5226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487645297 | Susan L Donohue | Nurse Practitioner | 4200 Lake Otis Pkwy, Suite 202, Anchorage, AK 99508-5215 | 2005-11-01 |
| 1669861753 | Anchorage Dental Care, LLC | Dentist | 4200 Lake Otis Pkwy, 201, Anchorage, AK 99508-5226 | 2015-01-13 |
| 1427454180 | Anna Berit Alcorn | Hearing Instrument Specialist | 4200 Lake Otis Pkwy, Suite 302, Anchorage, AK 99508-5226 | 2014-11-07 |
| 1801228788 | Heide Provencher | Nurse Practitioner | 4200 Lake Otis Pkwy, Anchorage, AK 99508-5226 | 2013-08-02 |
| 1376838714 | Christy Mary Jen | Dentist | 4200 Lake Otis Pkwy, Anchorage, AK 99508 | 2011-06-14 |
| 1417267337 | Anchorage Pediatric Dentistry, Inc | Dentist | 4200 Lake Otis Pkwy, Suite 102, Anchorage, AK 99508-5226 | 2010-10-13 |
| 1366764359 | Stephen G. Howard, Dds, Inc | Dentist | 4200 Lake Otis Pkwy, Suite #201, Anchorage, AK 99508-5226 | 2010-02-18 |
| 1912166240 | Theobold Gregory Remaklus | Dentist | 4200 Lake Otis Pkwy, Suite 102, Anchorage, AK 99508-5226 | 2008-06-02 |
| 1699952358 | Alaska Family Wellness Center Inc | Exclusive Provider Organization | 4200 Lake Otis Pkwy, Suite 304, Anchorage, AK 99508-5226 | 2008-01-24 |
| 1417147216 | Suzanne Lelevier | Audiologist | 4200 Lake Otis Pkwy, Suite 302, Anchorage, AK 99508-5226 | 2007-07-27 |
| 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 | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912514647 | Kaveri Bharti | Nurse Practitioner | 2900 Morgan Loop, Anchorage, AK 99516-1427 | 2020-09-27 |
| 1831709070 | China Kay Larson | Nurse Practitioner | 9402 Endicott St, Anchorage, AK 99502-1342 | 2020-08-03 |
| 1144847021 | Stephanie Anne Olah Packard | Nurse Practitioner | 6929 Crawford St, Anchorage, AK 99502-2728 | 2020-06-26 |
| 1811541790 | Mia Carlos Camaquin | Nurse Practitioner | 3900 Ambassador Dr Ste 3000, Anchorage, AK 99508-5922 | 2019-07-29 |
| 1275099632 | Marisa C Bune | Nurse Practitioner | 615 E 82nd Ave Ste 302, Anchorage, AK 99518-3159 | 2019-02-11 |
| 1518478569 | Alyeska Medical Staffing | Nurse Practitioner | 12201 Industry Way Ste 4, Anchorage, AK 99515-4316 | 2017-10-17 |
| 1902317035 | Julie Kane | Nurse Practitioner | 4361 Boniface Pkwy Ste 2, Anchorage, AK 99504-4314 | 2017-10-16 |
| 1215458682 | Kimberly Carter | Nurse Practitioner | 4120 Defiance St, Anchorage, AK 99504-4399 | 2017-07-06 |
| 1144763160 | Marina Nedom | Nurse Practitioner | 2501 Brooke Dr, Anchorage, AK 99517-1252 | 2016-11-22 |
| 1427506054 | Jessica Davis | Nurse Practitioner | 1824 Dimond Dr, Anchorage, AK 99507-1308 | 2016-09-12 |
| 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.