MEDICAL GROUP OF ALASKA (NPI# 1750730594) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750730594 |
| Entity Type | Organization |
| Organization Name | MEDICAL GROUP OF ALASKA |
| Practice Address |
3190 E Meridian Park Loop Ste 207 Wasilla AK 99654-7422 |
| Practice Telephone | 9073577710 |
| Practice Fax Number | 9073577720 |
| Mailing Telephone | 9073577710 |
| Mailing Fax Number | 9073577720 |
| Enumeration Date | 2016-06-10 |
| Last Update Date | 2020-01-24 |
| Authorized Official Name | CHRISTINE A HENRY-MUSSA (CEO) |
| Authorized Official Telephone | 9073577710 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 1019166 | AK | Allopathic & Osteopathic Physicians |
| 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 |
| 1669907606 | Medical Group of Alaska | Clinic/Center | 3190 E Meridian Park Loop, Suite 206b, Wasilla, AK 99654-7422 | 2017-04-27 |
| 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 STE 207 |
| City | WASILLA |
| State | AK |
| Zip Code | 99654-7422 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760028252 | Stefani Katherine Clements | Massage Therapist | 3190 E Meridian Park Loop Ste 207, Wasilla, AK 99654-7422 | 2019-11-20 |
| 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 | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104154913 | Integrated Care, LLC | General Practice | 540 E Hjellen Drive, Wasilla, AK 99654 | 2009-12-07 |
| 1912946310 | Alaska Physician Services,llc | General Practice | 3223 Palmer Wasilla Hwy, Ste 2, Wasilla, AK 99654-7236 | 2006-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659846293 | Premier Sports Medicine, Inc. | General Practice | 35670 Kenai Spur Hwy Ste 104, Soldotna, AK 99669-7649 | 2018-10-10 |
| 1801309042 | Online Care Group Alaska | General Practice | 200 W. 34th Ave, Anchorage, AK 99503 | 2017-11-09 |
| 1245763051 | Carlos Vargas | General Practice | 927 1st Ave, Fairbanks, AK 99701-4350 | 2017-04-07 |
| 1831580604 | Johnna L Kohl Md LLC | General Practice | 4001 Dale St Ste 201, Anchorage, AK 99508-5445 | 2015-02-13 |
| 1780072603 | Epoch - Alaska Limited Liability Company | General Practice | 3074 Mt. View Drive, Suite 193, Anchorage, AK 99501 | 2014-12-30 |
| 1598199028 | Nina Rodriguez | General Practice | 786 D St, Jber, AK 99505 | 2013-09-03 |
| 1518207992 | George Walter Seuffert Sr. | General Practice | Mile 75, Steese Hwy, Box 10297, Fairbanks, AK 99710 | 2013-02-22 |
| 1467708271 | Kevin Arthur Hall | General Practice | 25 Jefferson Way, Suite 102, Ketchikan, AK 99901-5953 | 2012-07-30 |
| 1063797827 | George Baryon Hightower | General Practice | Hc 89 34300 S Talkeetna Spur Road, Talkeetna, AK 99676 | 2011-10-12 |
| 1912295411 | Chadwick William Gaddis | General Practice | 4076 Neely Rd., Ft. Wainwright, AK 99703 | 2011-07-18 |
| Find all providers with the same taxonomy | ||||
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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.