DR. MARY ALICE JOHNSON (NPI# 1386759751) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386759751 |
| Entity Type | Individual |
| Full Name | DR. MARY ALICE JOHNSON |
| Credential | M.D. |
| Practice Address |
3340 Providence Dr Suite 366 Anchorage AK 99508-4616 |
| Practice Telephone | 9075633026 |
| Practice Fax Number | 9075626445 |
| Mailing Telephone | 9075633026 |
| Mailing Fax Number | 9075626445 |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2007-07-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
3976 | AK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | PENDING | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356953145 | Mary Ann Johnson | Technician | 165 Everett Dr, Gallipolis Ferry, WV 25515-7005 | 2020-08-21 |
| 1851938385 | Mary Johnson | Technician | 2917 W 19th Ave Trlr 79, Kennewick, WA 99337-2307 | 2019-12-03 |
| 1578106845 | Mary Margaret Johnson | Social Worker | 6614 Shallowford Rd. Suite 250, Lewisville, NC 27023 | 2019-10-19 |
| 1033670807 | Mary Bernece Johnson | Registered Nurse | 5603 Mandalay, Killeen, TX 76549-4597 | 2019-03-26 |
| 1295205342 | Mary Elizabeth Johnson | Speech-Language Pathologist | 502 W Windsor Rd, Champaign, IL 61820-7739 | 2018-12-03 |
| 1255825758 | Mary Elizabeth Johnson | Dietitian, Registered | 3590 Lucille Dr Ste 2600, Cincinnati, OH 45213-2669 | 2018-06-18 |
| 1871000463 | Mary James (jamie) Johnson | Counselor | 1100 Spring Street, Suite 380, Atlanta, GA 30309 | 2018-01-04 |
| 1841735289 | Mary Johnson | Registered Nurse | 14 Cypress Fairway Vlg, Wimberley, TX 78676-1974 | 2016-12-20 |
| 1467827220 | Mary Johnson | Registered Nurse | 308 Keelson Dr, Detroit, MI 48215-3058 | 2015-12-04 |
| 1003286055 | Mary Ann Johnson | Dentist | 320 Comanche St., Kiowa, CO 80117 | 2015-10-02 |
| Street Address |
3340 PROVIDENCE DR SUITE 366 |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99508-4616 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992706865 | Evelyn D Rider | Pediatrics | 3340 Providence Dr, Suite 366, Anchorage, AK 99508-4616 | 2005-08-02 |
| 1265967137 | Providence Imaging Center | Clinic/Center | 3340 Providence Dr, Anchorage, AK 99508 | 2017-04-27 |
| 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 |
| 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 | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992706865 | Evelyn D Rider | Pediatrics | 3340 Providence Dr, Suite 366, Anchorage, AK 99508-4616 | 2005-08-02 |
| 1114206042 | Connie Beiro Freeman | Pediatrics | 4320 Diplomacy Dr, Anchorage, AK 99508-5925 | 2011-08-09 |
| 1295786515 | Eric H Johnson | Pediatrics | 3340 Providence Dr, Suite 366, Anchorage, AK 99508-4616 | 2006-05-12 |
| 1326099656 | Lily J Lou | Pediatrics | 3340 Providence Dr, Suite 366, Anchorage, AK 99508-4616 | 2006-05-12 |
| 1295785707 | Kenneth Kesler | Pediatrics | 3340 Providence Dr, Suite 366, Anchorage, AK 99508-4616 | 2006-05-12 |
| 1598715864 | Emilio Avila | Pediatrics | 3340 Providence Dr, Suite 366, Anchorage, AK 99508-4616 | 2006-05-10 |
| 1437111093 | Jack Jacob | Pediatrics | 3340 Providence Dr, Suite 366, Anchorage, AK 99508-4616 | 2006-04-06 |
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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.