TRANQUILITY BEHAVIORAL TELEHEALTH LLC (NPI# 1306488572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306488572 |
| Entity Type | Organization |
| Organization Name | TRANQUILITY BEHAVIORAL TELEHEALTH LLC |
| Practice Address |
3137 Tongass Ave Ketchikan AK 99901-5745 |
| Mailing Address |
513 Memorial Blvd # 156 Springfield TN 37172-2905 |
| Practice Telephone | 6156045477 |
| Mailing Telephone | 6156045477 |
| Enumeration Date | 2019-10-09 |
| Last Update Date | 2020-10-15 |
| Authorized Official Name | SHANNON REA DAVIS (OWNER) |
| Authorized Official Telephone | 6156046577 |
| Authorized Official Credential | PMHNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3137 TONGASS AVE |
| City | KETCHIKAN |
| State | AK |
| Zip Code | 99901-5745 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346418829 | Wandra K. Miles, Md, Pllc | Plastic Surgery | 3137 Tongass Ave, Ketchikan, AK 99901-5745 | 2008-02-18 |
| 1508261702 | Shannon Rea Davis | Nurse Practitioner | 3137 Tongass Ave, Ketchikan, AK 99901-5745 | 2014-10-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992314215 | Residential Youth Care, Inc. | Community/Behavioral Health | 2442 Tongass Avenue, Ketchikan, AK 99901 | 2020-07-23 |
| 1316563026 | Residential Youth Care, Inc. | Community/Behavioral Health | 606 Hill Road, Ketchikan, AK 99901 | 2020-06-18 |
| 1043836851 | Residential Youth Care, Inc. | Community/Behavioral Health | 2514 1st Avenue, Ketchikan, AK 99901 | 2020-06-18 |
| 1215553029 | Residential Youth Care, Inc. | Community/Behavioral Health | 2951 Baranof Avenue, Ketchikan, AK 99901 | 2020-06-18 |
| 1174159222 | Helene Rae Simpson | Behavior Technician | 201 Deermont St, Ketchikan, AK 99901 | 2020-03-20 |
| 1003295155 | Suzanne Webb | Massage Therapist | 602 Dock St Ste 106, Ketchikan, AK 99901 | 2015-05-22 |
| 1093194342 | Kate Mortensen | Case Manager/Care Coordinator | 2690 Tongass Ave, Ketchikan, AK 99901 | 2015-05-20 |
| 1578879631 | Thomas Peter Ryan | Social Worker | 320 Bawden St. #318, Ketchikan, AK 99901 | 2010-08-27 |
| 1689820979 | Akeela Inc | Community Based Residential Treatment Facility, Mental Illness | 3050 Fifth Ave, Ketchikan, AK 99901 | 2008-08-18 |
| 1750565438 | Susan Marie Swift | Nurse Practitioner | 21 Jefferson Way, Suite 202, Psychiatry, Ketchikan, AK 99901 | 2007-12-18 |
| Find all providers in zip 99901 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366062903 | Eagle River Behavioral Health, LLC | Nurse Practitioner | 13125 Curry Ridge Cir, Eagle River, AK 99577-6730 | 2020-04-23 |
| 1760017123 | Sara Rottman | Nurse Practitioner | 2210 Sentry Dr Apt 14, Anchorage, AK 99507-5353 | 2020-03-05 |
| 1104464460 | David Ampong | Nurse Practitioner | 1577 C St Ste 204, Anchorage, AK 99501-5164 | 2019-12-18 |
| 1316597412 | Jennifer Byers Anp LLC | Nurse Practitioner | 1689 S Knik Goose Bay Rd Ste 700, Wasilla, AK 99654-8088 | 2019-09-19 |
| 1538720404 | Deanna Mae Casiano | Nurse Practitioner | 14460 E Pace Dr, Palmer, AK 99645-9964 | 2019-06-21 |
| 1154897429 | Kristerra Nicole Yawea | Nurse Practitioner | 2440 E Tudor Rd # 384, Anchorage, AK 99507-1185 | 2018-10-15 |
| 1982187399 | Sara A Lindsoe | Nurse Practitioner | 8136 White Dr, Anchorage, AK 99507-6046 | 2018-09-11 |
| 1245753656 | Richard Crisostomo | Nurse Practitioner | 3505 E Meridian Park Loop Ste 200, Wasilla, AK 99654-7242 | 2017-07-18 |
| 1609326594 | Virginia Walker | Nurse Practitioner | 3211 Providence Drive Rh Ste 116, University of Alaska Anchorage Student Health & Councel, Anchorage, AK 99508 | 2016-10-04 |
| 1922553726 | Adriana Maria Hernandez | Nurse Practitioner | 2405 S Knik Goose Bay Rd, Ste A, Wasilla, AK 99654-9965 | 2016-08-22 |
| Find all providers with the same taxonomy | ||||
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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.