PROVIDENCE IMAGING CENTER (NPI# 1265967137) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1265967137 |
Entity Type | Organization |
Organization Name | PROVIDENCE IMAGING CENTER |
Practice Address |
3340 Providence Dr Anchorage AK 99508 |
Mailing Address |
Po Box 4567 Portland OR 97208-4567 |
Practice Telephone | 9072123151 |
Practice Fax Number | 9072125828 |
Mailing Telephone | 9072123151 |
Enumeration Date | 2017-04-27 |
Last Update Date | 2018-08-10 |
Authorized Official Name | DON ANDERSON JR. (DIRECTOR REIMBURSEMENT ADMINISTRATI) |
Authorized Official Telephone | 4255255392 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QR0207X |
Clinic/Center Specialization: Radiology, Mobile Mammography |
48375 | AK | Ambulatory Health Care Facilities |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528006020 | Providence Imaging Center | Radiology | 3340 Providence Dr, Suite 101, Anchorage, AK 99508-4642 | 2006-06-04 |
Street Address |
3340 PROVIDENCE DR |
City | ANCHORAGE |
State | AK |
Zip Code | 99508 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992706865 | Evelyn D Rider | Pediatrics | 3340 Providence Dr, Suite 366, Anchorage, AK 99508-4616 | 2005-08-02 |
1053844019 | Stephanie S Fortt | Social Worker | 3340 Providence Dr, Suite A351, Anchorage, AK 99508-4691 | 2017-04-06 |
1407306434 | Haven Medical, LLC | Physician Assistant | 3340 Providence Dr, Ste 466, Anchorage, AK 99508-4691 | 2016-10-13 |
1962952234 | Megan Hurlburt | Dietitian, Registered | 3340 Providence Dr, Suite 358, Anchorage, AK 99508-4691 | 2016-10-10 |
1770968158 | Zachary Johnson | Physician Assistant | 3340 Providence Dr, Suite #a565, Anchorage, AK 99508-4691 | 2015-07-27 |
1235478553 | Jessica H Anderson | Physician Assistant | 3340 Providence Dr, Suite 565, Anchorage, AK 99508-4691 | 2013-02-06 |
1104174275 | Nicole Kopacz | Nurse Practitioner | 3340 Providence Dr, Suite 452, Anchorage, AK 99508-4691 | 2012-08-21 |
1922372598 | Northern Lights Surgical Associates, P.C. | Specialist | 3340 Providence Dr, Suite 363, Anchorage, AK 99508-4691 | 2012-02-29 |
1831480151 | Todd Alan Sneesby | Dentist | 3340 Providence Dr, Suite 560, Anchorage, AK 99508-4627 | 2011-04-20 |
1275857922 | Robert Rossero Md LLC | Internal Medicine | 3340 Providence Dr, Suite 466, Anchorage, AK 99508-4627 | 2010-03-24 |
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 | 261QR0207X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Radiology, Mobile Mammography |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487707790 | Breast Cancer Detection Center of Alaska and Charitable Corporation | Clinic/Center | 1905 Cowles St, Fairbanks, AK 99701-5914 | 2007-01-19 |
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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.