MEDICAL GROUP OF ALASKA (NPI# 1669907606) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669907606 |
| Entity Type | Organization |
| Organization Name | MEDICAL GROUP OF ALASKA |
| Other Organization Name | ALGONE REGENERATIVE MEDICINE |
| Practice Address |
3190 E Meridian Park Loop Suite 206b Wasilla AK 99654-7422 |
| Practice Telephone | 9073739460 |
| Practice Fax Number | 9073739461 |
| Mailing Telephone | 9073739460 |
| Mailing Fax Number | 9073739461 |
| Enumeration Date | 2017-04-27 |
| Last Update Date | 2020-02-14 |
| Authorized Official Name | CHARLIE FORBUSH (CEO) |
| Authorized Official Telephone | 9073739460 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDICAL GROUP OF ALASKA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP3300X |
Clinic/Center Specialization: Pain |
1050811 | AK | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Algone Regenerative Medicine | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588116909 | Medical Group of Alaska | Clinic/Center | 3190 E Meridian Park Loop, 206a, Wasilla, AK 99654-7422 | 2016-11-02 |
| 1750730594 | Medical Group of Alaska | General Practice | 3190 E Meridian Park Loop Ste 207, Wasilla, AK 99654-7422 | 2016-06-10 |
| 1023560752 | Medical Group of Alaska | Family Medicine | 3122 E Meridian Park Loop, Wasilla, AK 99654-7255 | 2016-10-28 |
| 1013469741 | Medical Group of Alaska | Clinic/Center | 3066 E Meridian Park Loop, Wasilla, AK 99654-7254 | 2016-10-28 |
| 1669924395 | Medical Group of Alaska | Family Medicine | 17025 Snowmobile Ln, Eagle River, AK 99577-7044 | 2016-10-28 |
| Street Address |
3190 E MERIDIAN PARK LOOP SUITE 206B |
| City | WASILLA |
| State | AK |
| Zip Code | 99654-7422 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588116909 | Medical Group of Alaska | Clinic/Center | 3190 E Meridian Park Loop, 206a, Wasilla, AK 99654-7422 | 2016-11-02 |
| 1912416579 | Pharmacy Partners, LLC | Pharmacy | 3190 E Meridian Park Loop, Suite 110, Wasilla, AK 99654 | 2017-09-27 |
| 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 | 261QP3300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Pain |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457433658 | Pioneer Peak Surgery Center, LLC | Clinic/Center | 3035 Palmer Wasilla Hwy, Suite 301, Wasilla, AK 99654-7234 | 2006-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174988539 | Primary Pain Solutions LLC | Clinic/Center | 7810 Canal St, Anchorage, AK 99502-4261 | 2015-12-29 |
| 1336524651 | Arctic Chiropractic and Physical Medicine | Clinic/Center | 107 A Alex Hately, Bethel, AK 99559-3466 | 2015-07-28 |
| 1750807988 | Lofthus, LLC | Clinic/Center | 16611 Farm Ave, Eagle River, AK 99577-7667 | 2017-08-18 |
| 1932436672 | Fairbanks Pain Consulting, LLC | Clinic/Center | 1919 Lathrop St, Suite 221, Fairbanks, AK 99701-5937 | 2009-11-16 |
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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.