PROVIDENCE HEALTH & SERVICES WASHINGTON (NPI# 1275869117) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275869117 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES WASHINGTON |
| Other Organization Name | PROVIDENCE IN HOME SERVICES |
| Practice Address |
4001 Dale St Suite 101 Anchorage AK 99508-5444 |
| Mailing Address |
3760 Piper St 1061 Anchorage AK 99508-4683 |
| Practice Telephone | 9072120256 |
| Mailing Telephone | 9072120256 |
| Enumeration Date | 2009-10-28 |
| Last Update Date | 2016-01-22 |
| Authorized Official Name | BILLIE JEAN MOUNTS (CHIEF REIMBURSEMENT OFFICER) |
| Authorized Official Telephone | 4256873910 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251G00000X | Hospice Care, Community Based | NOT NUMBERED | AK | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | NPI | 1992743561 | 01 |
| Other Name | Type Code |
|---|---|
| PROVIDENCE IN HOME SERVICES | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134656135 | Providence Health & Services Washington | Clinic/Center | 1018 Capitol Way S Ste 300, Olympia, WA 98501-1212 | 2017-05-22 |
| 1023550050 | Providence Health & Services Washington | Psychologist | 225 State Ave Ne, Olympia, WA 98501-6951 | 2016-11-08 |
| 1003367863 | Providence Health & Services Washington | Radiology | 4800 College St Se Ste E, Lacey, WA 98503-4389 | 2016-10-17 |
| 1023563897 | Providence Health & Services Washington | Clinic/Center | 1705 Se Meadowbrook Blvd, Suite 2, College Place, WA 99324-1756 | 2016-08-22 |
| 1457721250 | Providence Health & Services Washington | Clinic/Center | 1200 Basich Blvd, Aberdeen, WA 98520-1035 | 2015-10-06 |
| 1902141500 | Providence Health & Services Washington | Clinical Medical Laboratory | 820 S Mcclellan St Ste Ll10, Spokane, WA 99204-2446 | 2012-12-07 |
| 1881907715 | Providence Health & Services Washington | Internal Medicine | 62 W 7th Ave, Spokane, WA 99204-2321 | 2010-07-20 |
| 1073744850 | Providence Health & Services Washington | Rehabilitation, Substance Use Disorder Unit | 2505 Olympic Hwy N., Ste 140, Shelton, WA 98584-2978 | 2009-07-28 |
| 1770714693 | Providence Health & Services Washington | Rehabilitation, Substance Use Disorder Unit | 508 1/2 Eighth Street, Hoquiam, WA 98550-3521 | 2009-07-28 |
| 1033309604 | Providence Health & Services Washington | Family Medicine | 1450 Northwest Lane Se, Lacey, WA 98503-6908 | 2007-07-30 |
| Street Address |
4001 DALE ST SUITE 101 |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99508-5444 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376530170 | Matthew Lindemann | Obstetrics & Gynecology | 4001 Dale St, Ste #105, Anchorage, AK 99508-5428 | 2005-10-05 |
| 1265778922 | Melonie Rieck | Physical Therapist | 4001 Dale St, Suite 101, Anchorage, AK 99508-5428 | 2012-12-27 |
| 1083832802 | Providence Health & Services - Washington | Durable Medical Equipment & Medical Supplies | 4001 Dale St, Suite 101, Anchorage, AK 99508-5428 | 2007-04-24 |
| 1922128677 | Dwayne E Trujillo Md PC | Family Medicine | 4001 Dale St, Suite 216, Anchorage, AK 99508-5428 | 2007-03-29 |
| 1548385321 | Elizabeth Deschweinitz Md Apc | General Practice | 4001 Dale St, Suite 216, Anchorage, AK 99508-5428 | 2007-03-20 |
| 1992803019 | Beth Charlotte Cant | Family Medicine | 4001 Dale St, Suite Number 210, Anchorage, AK 99508-5428 | 2006-09-20 |
| 1275639353 | Carol Hebert | Nurse Practitioner | 4001 Dale St, Suite #105, Anchorage, AK 99508-5428 | 2006-09-15 |
| 1396841920 | Peter Adams | Obstetrics & Gynecology | 4001 Dale St, Suite #105, Anchorage, AK 99508-5428 | 2006-09-14 |
| 1558463497 | James M Foster | Pediatrics | 4001 Dale St, Suite 213, Anchorage, AK 99508 | 2006-09-01 |
| 1164532172 | Providence Health & Services Washington | Nursing Care | 4001 Dale St, Suite 101, Anchorage, AK 99508-5428 | 2006-08-30 |
| 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 | 251G00000X |
| Grouping | Agencies |
| Classification | Hospice Care, Community Based |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669862793 | Tlc Home Care LLC | Hospice Care, Community Based | 500 E Tudor Rd Ste 200, Anchorage, AK 99503-7377 | 2015-01-27 |
| 1891943049 | Anak Limited | Hospice Care, Community Based | 4360 Spenard Rd, Anchorage, AK 99517-2909 | 2008-08-29 |
| 1700094331 | Amazing Grace Alh | Hospice Care, Community Based | 3444 E 16th Ave, Anchorage, AK 99508-3037 | 2007-05-18 |
| 1861518375 | Randel Home Care | Hospice Care, Community Based | 9290 Aphrodite Dr, Anchorage, AK 99515-1498 | 2007-03-22 |
| 1093746893 | Maxim Healthcare Services, Inc. | Hospice Care, Community Based | 670 W Fireweed Ln, Suite 160, Anchorage, AK 99503-2562 | 2006-07-06 |
| 1831595685 | Frontier Home Health and Hospice, LLC | Hospice Care, Community Based | 3909 Artic Blvd, Anchorage, AK 99503-5770 | 2014-11-06 |
| 1346580776 | Bloom Alaska Healthcare Services, LLC | Hospice Care, Community Based | 341 W Tudor Rd, Suite 104, Anchorage, AK 99503-6639 | 2013-02-21 |
| 1619160520 | Amedisys Alaska, L.L.C. | Hospice Care, Community Based | 3909 Arctic Blvd, Suites 101 and 102, Anchorage, AK 99503-5770 | 2007-08-23 |
| 1659345734 | Integricare, Inc. | Hospice Care, Community Based | 3935 Reka Dr, Anchorage, AK 99508-3517 | 2006-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801380043 | Ancora Home Health & Hospice, LLC | Hospice Care, Community Based | 950 E Bogard Rd Ste 132, Wasilla, AK 99654-7172 | 2018-06-20 |
| 1104185214 | Banner Home Care Arizona | Hospice Care, Community Based | 2001 Gillam Way, Fairbanks, AK 99701-6026 | 2012-05-09 |
| 1093821373 | Catholic Community Service Inc | Hospice Care, Community Based | 419 6th St, Juneau, AK 99801-1020 | 2006-08-21 |
| 1477047579 | Ancora Home Health & Hospice, LLC | Hospice Care, Community Based | 950 E Bogard Rd Ste 132, Wasilla, AK 99654-7172 | 2018-06-21 |
| 1881145571 | Fairbanks Memorial Hospital, LLC | Hospice Care, Community Based | 2001 Gillam Way, Fairbanks, AK 99701-6026 | 2016-10-18 |
| 1659722288 | Aurora Borealis Hospice LLC | Hospice Care, Community Based | 4900 E Palmer Wasilla Hwy Ste 4, Wasilla, AK 99654-7752 | 2016-06-24 |
| 1174847743 | Amedisys Alaska, LLC | Hospice Care, Community Based | 892 E Usa Cir, Suite 102, Wasilla, AK 99654-7188 | 2010-03-25 |
| 1750567640 | Mat-su Valley II LLC | Hospice Care, Community Based | 950 E Bogard Rd, Suite 132, Wasilla, AK 99654-7105 | 2008-01-10 |
| 1669425898 | Mat Su Valley Medical Center LLC | Hospice Care, Community Based | 3051 Palmer Wasilla Hwy, Wasilla, AK 99654-7234 | 2006-05-18 |
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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.