JESSE ATWOOD MD PEDIATRICS, LLC (NPI# 1669858106) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669858106 |
| Entity Type | Organization |
| Organization Name | JESSE ATWOOD MD PEDIATRICS, LLC |
| Other Organization Name | JESSE ATWOOD MD PEDIATRICS |
| Practice Address |
2500 S Woodworth Loop Palmer AK 99645-8984 |
| Mailing Address |
Po Box 876166 Wasilla AK 99687-6166 |
| Practice Telephone | 9078616000 |
| Enumeration Date | 2015-08-06 |
| Last Update Date | 2016-11-18 |
| Authorized Official Name | DR. JESSE WILLIAM ATWOOD (PRESIDENT) |
| Authorized Official Telephone | 9078616000 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 7328 | AK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | MD4770 | 05 |
| Other Name | Type Code |
|---|---|
| Jesse Atwood MD Pediatrics | Doing Business As Name - Organization |
| Street Address |
2500 S WOODWORTH LOOP |
| City | PALMER |
| State | AK |
| Zip Code | 99645-8984 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629067590 | Roy Fukuoka | Nurse Anesthetist, Certified Registered | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2005-10-13 |
| 1720603939 | Robert A Grogan | Pharmacist | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2020-06-12 |
| 1184258170 | Michelle Hailey Allen | Registered Nurse | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2020-02-27 |
| 1528615424 | Tara E Bonardi | Nurse Anesthetist, Certified Registered | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2019-08-25 |
| 1619532215 | Eric Atkinson | Registered Nurse | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2019-05-08 |
| 1588133748 | Erin Alaina Reding | Nurse Practitioner | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2018-11-17 |
| 1043722929 | Fireweed Surgical Assists LLC | Nurse Practitioner | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2017-10-31 |
| 1740713866 | Annette Kasprzak | Emergency Medicine | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2017-04-05 |
| 1881080018 | Kili Grace O'bryant | Emergency Medicine | 2500 S Woodworth Loop, Palmer, AK 99645 | 2015-04-14 |
| 1205229341 | Meghan Barnett Sonnabend | Physician Assistant | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2015-03-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295357135 | Kasey M Flintoft | Occupational Therapist | 7200 E. Jim Cottrell Cir, Palmer, AK 99645 | 2020-05-14 |
| 1629601471 | Courtney Randol | Licensed Practical Nurse | 14405 E Pace Dr., Palmer, AK 99645 | 2020-02-20 |
| 1689213092 | Valerie Anne Delaune | Acupuncturist | 9693 N. Little Otter Dr., Palmer, AK 99645 | 2020-01-02 |
| 1003464512 | Alaskan Sunrise Behavioral Health, L.L.C. | Clinic/Center | 14460 E. Pace Dr., Palmer, AK 99645 | 2019-08-28 |
| 1548814718 | Maple Springs of Palmer Snf Holdings, LLC | Skilled Nursing Facility | 12130 E Maple Springs Way, Palmer, AK 99645 | 2019-07-26 |
| 1952868655 | Carla Beth Kelly | Physical Therapist | 7200 Jim Cottrell Circle, Palmer, AK 99645 | 2019-02-28 |
| 1366938375 | Wendy S Page | Behavior Technician | 7200 E Jim Cottrell, Wasilla, AK 99645 | 2018-07-03 |
| 1154845170 | Sarah Elizabeth Gilliland | Occupational Therapist | 7200 E Jim Cottrell Circle, Palmer, AK 99645 | 2017-08-01 |
| 1558885137 | Garland Brooks | Massage Therapist | 1934 Prospect Dr, Palmer, AK 99645 | 2017-07-26 |
| 1386165009 | Sommer Dawn Nielsen | Massage Therapist | 3566 N Mars Ave., Palmer, AK 99645 | 2017-07-03 |
| Find all providers in zip 99645 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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/certificatio - 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 |
|---|---|---|---|---|
| 1093720534 | Providence Health & Services - Washington | Pediatrics | 2250 S. Woodworth Loop, Suite 101, Palmer, AK 99645 | 2006-07-31 |
| 1184639775 | Therese K Tomasoski | Pediatrics | 2250 South Woodworth Loop, Suite 101, Palmer, AK 99645-7457 | 2006-07-30 |
| 1649381609 | Dilipkumar S Vagal | Pediatrics | 40 Wright St, Palmer, MA 01069-1138 | 2006-08-31 |
| 1700894664 | Jesse W Atwood | Pediatrics | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2006-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629543046 | Pacific Pediatrics, LLC | Pediatrics | 63 Higgins Spur, Ketchikan, AK 99901-9442 | 2018-10-11 |
| 1780195727 | Amanda Kathleen Dunlap | Pediatrics | 3340 Providence Dr Ste A-452, Anchorage, AK 99508-4691 | 2017-10-17 |
| 1841663945 | Jennifer Elisabeth Austin | Pediatrics | 751 E 36th Ave Ste 100, Anchorage, AK 99503 | 2015-11-11 |
| 1295112159 | Jacob Eby | Pediatrics | 673 Mdg 5955 Zeamer Ave, Jber, AK 99506 | 2015-04-29 |
| 1821409137 | Denise Frohlich Jones | Pediatrics | Alaska Neonatology Assoc, 3340 Providence Dr. Suite 366, Anchorage, AK 99508 | 2014-05-08 |
| 1780003376 | Carolyn Roloff | Pediatrics | 3200 Providence Dr Fl 3, Anchorage, AK 99508 | 2014-04-10 |
| 1154755056 | Begich School Based Health Center | Pediatrics | 7440 Creekside Center Dr, Anchorage, AK 99504-5234 | 2013-08-27 |
| 1710262175 | Anchorage School Based Health Centers | Pediatrics | 150 Bragaw St, Anchorage, AK 99508-1307 | 2011-10-18 |
| 1164719423 | Scott Edward Stewart | Pediatrics | 673rd Mdg, 5955 Zeamer Ave, Jber, AK 99506 | 2011-07-06 |
| 1003142621 | Mat-su Community Pediatrics, P.C. | Pediatrics | 3750 E. Country Field Circle, Suite C, Wasilla, AK 99654 | 2009-11-02 |
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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.