CAPSTONE FAMILY MEDICINE LLC (NPI# 1487040309) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487040309 |
| Entity Type | Organization |
| Organization Name | CAPSTONE FAMILY MEDICINE LLC |
| Other Organization Name | WADE ERICKSON MD |
| Practice Address |
3122 E Meridian Park Loop Wasilla AK 99654-7294 |
| Mailing Address |
6501 City West Pkwy Eden Prairie MN 55344-3248 |
| Practice Telephone | 9073579590 |
| Mailing Telephone | 9526532525 |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2015-04-07 |
| Authorized Official Name | WADE ERICKSON (MD) |
| Authorized Official Telephone | 9073579590 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | CAPSTONE FAMILY MEDICINE LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | Suppliers |
| Other Name | Type Code |
|---|---|
| Wade Erickson MD | Other Name - Individual/Organization |
| Street Address |
3122 E MERIDIAN PARK LOOP |
| City | WASILLA |
| State | AK |
| Zip Code | 99654-7294 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508089046 | Medical Network of Alaska, LLC | Specialist | 3122 E Meridian Park Loop, Wasilla, AK 99654-7255 | 2007-04-11 |
| 1992344923 | Cap Eye LLC | Optometrist | 3122 E Meridian Park Loop, Wasilla, AK 99654-7255 | 2019-12-20 |
| 1013558360 | Medical Network of Alaska, LLC | Obstetrics & Gynecology | 3122 E Meridian Park Loop, Wasilla, AK 99654-7255 | 2019-10-07 |
| 1023560752 | Medical Group of Alaska | Family Medicine | 3122 E Meridian Park Loop, Wasilla, AK 99654-7255 | 2016-10-28 |
| 1528353877 | Jim Mattson Cook | Family Medicine | 3122 E Meridian Park Loop, Wasilla, AK 99654 | 2011-06-15 |
| 1538395397 | Tracy J Slager | Family Medicine | 3122 E Meridian Park Loop, Wasilla, AK 99654-7294 | 2009-06-08 |
| 1821269309 | Capstone Eye Clinic, LLC | Optometrist | 3122 E Meridian Park Loop, Wasilla, AK 99654-7255 | 2008-03-12 |
| 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 | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023404738 | Capstone Urgent Care LLC | Non-Pharmacy Dispensing Site | 3066 E Meridian Park Loop, Wasilla, AK 99654-7372 | 2015-04-09 |
| 1578953253 | Capstone Urgent Care LLC | Non-Pharmacy Dispensing Site | 3066 E Meridian Park Loop, Wasilla, AK 99654-7372 | 2015-02-02 |
| 1306023452 | Capstone Family Medical | Non-Pharmacy Dispensing Site | 3223 E Palmer Wasilla Hwy, Wasilla, AK 99654-7236 | 2008-01-30 |
| 1215130372 | Alaska Brain Center, LLC | Non-Pharmacy Dispensing Site | 4551 E Bogard Rd, Wasilla, AK 99654-6075 | 2007-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548391162 | Alaska Optical Service,inc | Non-Pharmacy Dispensing Site | 554 E 3rd Ave, Anchorage, AK 99501-2620 | 2007-03-07 |
| 1114026069 | Family Medical Center | Non-Pharmacy Dispensing Site | 2360 Service St, Delta Junction, AK 99737 | 2006-09-21 |
| 1922071117 | Sunshine Community Health Center Inc | Non-Pharmacy Dispensing Site | 35300 S Talkeetna Spur Rd, Talkeetna, AK 99676 | 2006-02-09 |
| 1033364138 | Sunshine Community Health Center Inc | Non-Pharmacy Dispensing Site | Mile 4.4 Talkeetna Spur Road, Talkeetna, AK 99767-0787 | 2008-11-18 |
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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.