NEUROVERSION (NPI# 1487102208) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487102208 |
| Entity Type | Organization |
| Organization Name | NEUROVERSION |
| Practice Address |
2925 Debarr Rd Suite 240 Anchorage AK 99508-2959 |
| Practice Telephone | 9073394650 |
| Mailing Telephone | 8185235372 |
| Enumeration Date | 2016-09-21 |
| Last Update Date | 2016-12-19 |
| Authorized Official Name | LUKE LIU (OWNER) |
| Authorized Official Telephone | 8185235372 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
MEDS6555 | AK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | 1654351 | 05 |
| Street Address |
2925 DEBARR RD SUITE 240 |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99508-2959 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174593750 | Cynthia A Joe | Internal Medicine | 2925 Debarr Rd, Alaska Va Healthcare System (11), Anchorage, AK 99508-2983 | 2006-01-25 |
| 1306292818 | Internal Medicine Primary Care | Internal Medicine | 2925 Debarr Rd, Bld D, 215, Anchorage, AK 99508-2959 | 2016-05-13 |
| 1760836282 | Wanda Wilson | Specialist | 2925 Debarr Rd, Suite 150, Anchorage, AK 99508-2959 | 2016-04-21 |
| 1760852388 | Vitae Integrative Medical Center | Clinic/Center | 2925 Debarr Rd, Suite 150, Anchorage, AK 99508-2959 | 2015-09-26 |
| 1972845089 | Daniel James Hibbard | Pediatrics | 2925 Debarr Rd, Suite 230, Anchorage, AK 99508-2959 | 2013-03-27 |
| 1215232293 | Catherine A Butler | Nurse Practitioner | 2925 Debarr Rd, Suite 230, Anchorage, AK 99508-2959 | 2011-01-21 |
| 1235452640 | Jocelyn Lowe | Occupational Therapist | 2925 Debarr Rd, Anchorage, AK 99508-2983 | 2010-03-12 |
| 1548599467 | Roland B Cabiad | Registered Nurse | 2925 Debarr Rd, Anchorage, AK 99508-2983 | 2009-12-24 |
| 1790014215 | Jennifer Marie Kapolchok | Social Worker | 2925 Debarr Rd, Suite 2600, Anchorage, AK 99508-2983 | 2009-12-11 |
| 1336477181 | Carol Anne Hogins-wolfe | Social Worker | 2925 Debarr Rd, Anchorage, AK 99508-2983 | 2009-12-04 |
| 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 | 208VP0014X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Interventional Pain Medicine |
| Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417996307 | Tamara Ann Brothers Mcneil | Pain Medicine | 100 Trading Bay Rd Ste 8, Kenai, AK 99611-7786 | 2006-06-06 |
| 1790776599 | Eric F Severson | Pain Medicine | 3066 E Meridian Park Loop Ste 207, Wasilla, AK 99654-7254 | 2005-10-31 |
| 1518300185 | Pain and Headache Center, LLC | Pain Medicine | 12836 Old Glenn Hwy Ste 2, Eagle River, AK 99577 | 2013-04-12 |
| 1609176783 | Algone Center | Pain Medicine | 3066 E Meridian Park Loop, #1, Wasilla, AK 99654-7299 | 2010-10-23 |
| 1407171069 | Northern Anesthesia and Pain Medicine, LLC | Pain Medicine | 10928 Eagle River Rd, Suite 240, Eagle River, AK 99577-8078 | 2010-04-06 |
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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.