FAMILY DIABETES CLINIC (NPI# 1801174586) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801174586 |
| Entity Type | Organization |
| Organization Name | FAMILY DIABETES CLINIC |
| Practice Address |
1407 W 31st Ave Ste. 600 Anchorage AK 99503-3678 |
| Mailing Address |
1407 W 31st Ave Ste. 200 Anchorage AK 99503-3678 |
| Practice Telephone | 9076773750 |
| Practice Fax Number | 9076773751 |
| Mailing Telephone | 9076773750 |
| Mailing Fax Number | 9076773751 |
| Enumeration Date | 2011-07-28 |
| Last Update Date | 2011-11-18 |
| Authorized Official Name | TRACY L MICHALSKI (OWNER) |
| Authorized Official Telephone | 9076773750 |
| Authorized Official Credential | ANP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SF0001X |
Clinical Nurse Specialist Specialization: Family Health |
688 | AK | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | MPG0391 | 05 |
| Street Address |
1407 W 31ST AVE STE. 600 |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99503-3678 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871697342 | Cynthia Allen Ebelacker | Registered Nurse | 1407 W 31st Ave, Suite 201, Anchorage, AK 99503-3678 | 2006-09-12 |
| 1114275369 | Dana B Brokofsky | Counselor | 1407 W 31st Ave, Ste. 400, Anchorage, AK 99503-3678 | 2012-08-20 |
| 1679875819 | Damon J Pemberton | Social Worker | 1407 W 31st Ave, Ste, 400, Anchorage, AK 99503-3678 | 2010-11-19 |
| 1649571142 | Seeganna Psychiatric Services | Nurse Practitioner | 1407 W 31st Ave, Ste. 201d, Anchorage, AK 99503-3678 | 2010-11-15 |
| 1073847943 | Cynthia Ebelacker, Anp | Nurse Practitioner | 1407 W 31st Ave, Ste 201, Anchorage, AK 99503-3678 | 2009-09-25 |
| 1700028727 | Anne Marie Zack, Anp,co,apc | Nurse Practitioner | 1407 W 31st Ave, Ste.201, Anchorage, AK 99503-3678 | 2009-04-06 |
| 1821258815 | Bruce Nairn Smith | Psychologist | 1407 W 31st Ave, Suite 602, Anchorage, AK 99503-3678 | 2008-06-12 |
| 1477743532 | Greatland Mental Health, LLC | Counselor | 1407 W 31st Ave, Ste 201, Anchorage, AK 99503-3678 | 2007-07-25 |
| 1467674333 | Anne Marie Zack | Nurse Practitioner | 1407 W 31st Ave, Suite 301, Anchorage, AK 99503-3624 | 2007-05-02 |
| 1801925599 | Susan Lagrande | Psychologist | 1407 W 31st Ave, Suite 602, Anchorage, AK 99503-3624 | 2007-03-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164020772 | Miladis Mcduffie | Massage Therapist | 1350 W. Northern Lights Blvd, Ste C, Anchorage, AK 99503 | 2020-10-15 |
| 1447804984 | Bethany Lynn Becker | Optometrist | 401 E. Northern Lights Blvd. Suite 102, Anchorage, AK 99503 | 2019-08-01 |
| 1265084933 | Carr-gottstein Foods Co | Durable Medical Equipment & Medical Supplies | 2920 Seward Hwy, Anchorage, AK 99503 | 2019-07-12 |
| 1982268942 | Rukiyia Smith | Behavior Technician | 205 E Northern Lights Blvd, Suite 110, Anchorage, AK 99503 | 2019-04-25 |
| 1245894310 | Mary Kathleen Tate | Specialist/Technologist | 205 E. Northern Lights Blvd, Suite 110, Anchorage, AK 99503 | 2019-04-24 |
| 1194295766 | Kimberly Sue Trent | Registered Nurse | 670 W. Fireweed Lane Suite 160, Anchorage, AK 99503 | 2018-11-27 |
| 1659869089 | Alaska Spine & Pain Center, LLC | Chiropractor | 3901 Old Seward Hwy Ste 11, Anchorage, AK 99503 | 2018-05-01 |
| 1235643123 | Rosanne Louise Klouda | Massage Therapist | 213 Fireweed Ln, Anchorage, AK 99503 | 2017-11-30 |
| 1801309042 | Online Care Group Alaska | General Practice | 200 W. 34th Ave, Anchorage, AK 99503 | 2017-11-09 |
| 1548773849 | Leslie K Michalski | Massage Therapist | 510 W Tudor Rd Ste 9, Anchorage, AK 99503 | 2017-11-08 |
| Find all providers in zip 99503 | ||||
| Taxonomy Code | 364SF0001X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Family Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487111084 | Andrea Birch | Clinical Nurse Specialist | 3851 Piper St Ste U340, Anchorage, AK 99508-6904 | 2019-03-01 |
| 1790974079 | Kyna Powers | Clinical Nurse Specialist | 300 E. Dimond Blvd., Suite 12, Anchorage, AK 99515 | 2007-10-23 |
| 1013313923 | Erica Fossler | Clinical Nurse Specialist | 3851 Piper St, Anchorage, AK 99508-4684 | 2014-11-05 |
| 1083929962 | Diana C. Svede | Clinical Nurse Specialist | 1217 E 10th Ave, Anchorage, AK 99501-4003 | 2010-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255764163 | Mindona I Billings | Clinical Nurse Specialist | 1717 Cowles St, Fairbanks, AK 99701-5926 | 2013-08-14 |
| 1396916383 | Donna M Paul | Clinical Nurse Specialist | 320 Bennett St, Wrangell, AK 99929-1231 | 2008-03-18 |
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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.