MAT-SU VALLEY III LLC (NPI# 1366752560) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366752560 |
| Entity Type | Organization |
| Organization Name | MAT-SU VALLEY III LLC |
| Practice Address |
950 E Bogard Rd Suite 207 Wasilla AK 99654-7184 |
| Practice Telephone | 9078640260 |
| Practice Fax Number | 9078640262 |
| Mailing Telephone | 9078640260 |
| Mailing Fax Number | 9078640262 |
| Enumeration Date | 2010-10-21 |
| Last Update Date | 2013-07-30 |
| Authorized Official Name | SOPHIA ARWOOD (DIRECTOR) |
| Authorized Official Telephone | 6156286038 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | MPG0314 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861935975 | Mat-su Valley IIi LLC | Clinic/Center | 5851 South Knik-goose Bay Road, Wasilla, AK 99623 | 2016-11-21 |
| 1518472984 | Mat-su Valley IIi LLC | Clinic/Center | 209 W Evergreen Ave, Palmer, AK 99645-6952 | 2017-12-07 |
| Street Address |
950 E BOGARD RD SUITE 207 |
| City | WASILLA |
| State | AK |
| Zip Code | 99654-7184 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831188473 | Laura Jean Peterson | Pediatrics | 950 E Bogard Rd, Ste 233, Wasilla, AK 99654-7184 | 2005-10-17 |
| 1801314927 | Tracie East | Physical Therapist | 950 E Bogard Rd, Wasilla, AK 99654-7184 | 2017-09-08 |
| 1346776150 | Patricia B Payne | Nurse Practitioner | 950 E Bogard Rd, Suite #228, Wasilla, AK 99654-7184 | 2017-05-11 |
| 1578928628 | Gagnon Plastic and Reconstructive Surgery | Plastic Surgery | 950 E Bogard Rd, Suite 209, Wasilla, AK 99654-7184 | 2015-12-16 |
| 1659700292 | Hillary Ryan Linden | Physician Assistant | 950 E Bogard Rd, Suite 103, Wasilla, AK 99654-7184 | 2013-11-04 |
| 1578995304 | Mat-su Neurology, LLC | Clinic/Center | 950 E Bogard Rd, Suite 213, Wasilla, AK 99654-7184 | 2013-08-03 |
| 1114269313 | Odland Family Practice Clinic, LLC | Family Medicine | 950 E Bogard Rd, Suite 234, Wasilla, AK 99654-7184 | 2013-03-26 |
| 1619212479 | Janet L Shelley | Nurse Practitioner | 950 E Bogard Rd, Suite 233, Wasilla, AK 99654-7184 | 2012-12-05 |
| 1700013570 | David Dwight Buckland | Psychiatry & Neurology | 950 E Bogard Rd, Suite 213, Wasilla, AK 99654-7184 | 2009-06-18 |
| 1497900278 | Rebecca J. Moore | Dietitian, Registered | 950 E Bogard Rd, Suite 207, Wasilla, AK 99654-7184 | 2008-11-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003426784 | Colleen Maggie Newcity | Case Manager/Care Coordinator | 851 Westpoint Suite 310, Wasilla, AK 99654 | 2020-08-06 |
| 1659995884 | Amy M Lowe | Peer Specialist | 1363 W Spuce Ave, Wasilla, AK 99654 | 2020-06-03 |
| 1922648690 | Achieve Medical Alaska LLC | Clinic/Center | 1981 E Palmer, Suite 230, Wasilla, AK 99654 | 2020-01-10 |
| 1588205538 | Juan Carlos Garcia | Physician Assistant | 950 East Bogard Road, Suite 103, Wasilla, AK 99654 | 2019-10-01 |
| 1427610864 | Sharon Webb | Counselor | 705 S Knik Goose Bay Rd Suite K, Wasilla, AK 99654 | 2019-07-06 |
| 1306401864 | Logan Lee Cook | Peer Specialist | 2953 E Fairview Loop, Wasilla, AK 99654 | 2019-05-09 |
| 1053883595 | Moose Creek Medical Clinic LLC | Nurse Practitioner | 2341 S. Fern St., Suite 300, Wasilla, AK 99654 | 2018-12-21 |
| 1487124962 | Melissa A Stevens | Massage Therapist | 2201 W That Rd, Wasilla, AK 99654 | 2018-11-28 |
| 1609359561 | Audrey E Beers | Midwife | 2405 S. Knik Goose Bay Rd., Wasilla, AK 99654 | 2018-09-07 |
| 1093297418 | Karlee Janine Mccorry | Occupational Therapist | 613 S Knik-goose Bay Rd, Wasilla, AK 99654 | 2018-09-01 |
| Find all providers in zip 99654 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427133958 | Partners In Health Medical Clinic | Internal Medicine | 472 N Main St, Suite B, Wasilla, AK 99654-7018 | 2006-10-25 |
| 1861437311 | John D Hunter | Internal Medicine | 1751 Gardner Way, Ste D, Wasilla, AK 99654-6513 | 2006-06-18 |
| 1164479374 | Loetta Mae Horswill-woods | Internal Medicine | 3719 E Meridian Loop, Suite F, Wasilla, AK 99654-7270 | 2006-05-31 |
| 1124081211 | David Barnes | Internal Medicine | 3719 E Meridian Loop Ste A, Wasilla, AK 99654-7273 | 2006-04-10 |
| 1699734673 | Richard J Zajac | Internal Medicine | 950 Bogard Rd, 207, Wasilla, AK 99654-7105 | 2006-03-20 |
| 1134523855 | Cottonwood Creek Clinic LLC | Internal Medicine | 3600 E Wickersham Way, Wasilla, AK 99654-7550 | 2014-10-09 |
| 1316289176 | John D Hunter, Md Inc | Internal Medicine | 1751 E Gardner Way, Ste D, Wasilla, AK 99654-6564 | 2013-03-20 |
| 1962705202 | Heritage Medical Group LLC | Internal Medicine | 501 N Knik St, Wasilla, AK 99654-7050 | 2010-12-08 |
| 1841405883 | Carole Suzanne Ruegsegger | Internal Medicine | 3750 E Country Field Cir, Unit B, Wasilla, AK 99654-6689 | 2007-05-12 |
| 1063529550 | Dirk B Craft | Internal Medicine | 3719 E Meridian Loop, Ste A, Wasilla, AK 99654 | 2006-08-23 |
| Find all providers in WASILLA | ||||
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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.