PENINSULA NEUROLOGY LLC (NPI# 1376791707) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376791707 |
| Entity Type | Organization |
| Organization Name | PENINSULA NEUROLOGY LLC |
| Other Organization Name | ALYESKA NEUROLOGY |
| Practice Address |
206 W Rockwell Ave Ste 100 Soldotna AK 99669-7411 |
| Practice Telephone | 9072627700 |
| Practice Fax Number | 9072620809 |
| Mailing Telephone | 9072627700 |
| Mailing Fax Number | 9072620809 |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2008-08-27 |
| Authorized Official Name | DR. KRISTEN JESSEN (PHYSICIAN) |
| Authorized Official Telephone | 9072627700 |
| Authorized Official Credential | M.D., PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
4795 | AK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | MD0369 | 05 |
| Other Name | Type Code |
|---|---|
| Alyeska Neurology | Doing Business As Name - Organization |
| Street Address |
206 W ROCKWELL AVE STE 100 |
| City | SOLDOTNA |
| State | AK |
| Zip Code | 99669-7411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154334381 | Lavern R Davidhizar | Family Medicine | 206 W Rockwell Ave, Suite 100, Soldotna, AK 99669-7411 | 2006-08-15 |
| 1508300922 | Joanna Oliver Walls | Registered Nurse | 206 W Rockwell Ave, #100, Soldotna, AK 99669-7439 | 2016-12-05 |
| 1730459389 | Jolynn Montgomery | Physician Assistant | 206 W Rockwell Ave, Ste 100, Soldotna, AK 99669-7411 | 2012-01-12 |
| 1073701421 | Family Medical Clinic | Anesthesiology | 206 W Rockwell Ave, Suite 100, Soldotna, AK 99669-7411 | 2007-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881201226 | Kyle Arron Shassetz | Counselor | 43335 K-beach Rd., Soldotna, AK 99669 | 2020-09-29 |
| 1720614993 | Peninsula Instacare | Clinic/Center | 34581 Kenai Spur Hwy, Suite 1, Soldotna, AK 99669 | 2020-03-19 |
| 1871141077 | Alaine Viola Lagasse | Counselor | Kenai Vet Center, 43299 Kalifornsky Beach Road Ste 4, Soldotna, AK 99669 | 2019-08-30 |
| 1962970574 | Ryder R Storm | Behavior Technician | 338800 Community College Drive, Suite 1, Soldotna, AK 99669 | 2018-11-13 |
| 1356821540 | Tanecia Webster | Nurse Practitioner | 36570 Kenai Spur Hwy, Ste 103a, Soldotna, AK 99669 | 2018-08-16 |
| 1821519869 | Theresa Napolitano | Case Manager/Care Coordinator | 35477 Kenai Spur Hwy Suite 203, Soldotna, AK 99669 | 2017-06-29 |
| 1689048282 | Jeanne Bignell | Licensed Practical Nurse | 35020 Alaskan View Lane, Soldotna, AK 99669 | 2015-11-19 |
| 1952786105 | Ian Charles Mcmullen | Pharmacist | 44001 Sterling Highway, Soldotna, AK 99669 | 2015-07-29 |
| 1841679933 | Lana Clymer | Case Manager/Care Coordinator | 22994 Kalifornsky Beach Rd, Soldotna, AK 99669 | 2015-05-22 |
| 1861800773 | Phillip Bruce | Physical Therapy Assistant | 35105 Kenai Spury Hwy, Suite A, Soldotna, AK 99669 | 2014-07-24 |
| Find all providers in zip 99669 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255423869 | Charles George Perkins | Psychiatry & Neurology | 167 Warehouse Ave, Suite C, Soldotna, AK 99669 | 2006-09-29 |
| 1629171608 | Kristen B Jessen | Psychiatry & Neurology | 289 N Fireweed St Ste D, Soldotna, AK 99669-7570 | 2006-09-06 |
| 1912965864 | Elaine Celeste Jones | Psychiatry & Neurology | 262 N Binkley St, Soldotna, AK 99669-7522 | 2006-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770814923 | Jason E Polchinski | Psychiatry & Neurology | 3900 Ambassador Dr, Anchorage, AK 99508 | 2010-01-27 |
| 1578701033 | Marci L Troxell | Psychiatry & Neurology | 2841 Debarr Rd Ste 32, Anchorage, AK 99508-2967 | 2009-01-21 |
| 1710157995 | North Pacific Neuromonitoring Associates, P.C. | Psychiatry & Neurology | 2100 N Star St, Anchorage, AK 99503-1819 | 2008-03-04 |
| 1457426744 | Susan E Hunter-joerns | Psychiatry & Neurology | 2205 Jordan Ave, Juneau, AK 99801-8050 | 2006-11-21 |
| 1912078833 | Shirley H Fraser | Psychiatry & Neurology | 1200 I St, #704, Anchorage, AK 99501 | 2006-11-13 |
| 1801808969 | Stanford W. Downs | Psychiatry & Neurology | 2741 Debarr Rd Ste 413, Anchorage, AK 99508-2953 | 2006-08-13 |
| 1831115955 | Peter J Osterbauer | Psychiatry & Neurology | 3035 E Palmer Wasilla Hwy Ste 301, Wasilla, AK 99654-7274 | 2006-07-14 |
| 1346200227 | Kim E Madden | Psychiatry & Neurology | 4141 B St, Suite 401, Anchorage, AK 99503-5940 | 2006-03-24 |
| 1972042612 | Alaska Inpatient Neurology Services, LLC | Psychiatry & Neurology | 2741 Debarr Rd, Suite 413, Anchorage, AK 99508-2961 | 2017-02-14 |
| 1043675648 | Janice Onorato, Md, LLC | Psychiatry & Neurology | 1867 Airport Way, Suite 205, Fairbanks, AK 99701-4054 | 2015-12-23 |
| 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.