ALASKAN LEGACY PODIATRIC FOOT & ANKLE SPECIALIST LLC (NPI# 1861809311) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861809311 |
| Entity Type | Organization |
| Organization Name | ALASKAN LEGACY PODIATRIC FOOT & ANKLE SPECIALIST LLC |
| Practice Address |
4001 Laurel St Suite 209 Anchorage AK 99508-5300 |
| Practice Telephone | 9076440442 |
| Mailing Telephone | 9076440442 |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2014-11-13 |
| Authorized Official Name | DR. ELISA LEAR-RAYBORN (PHYSICIAN) |
| Authorized Official Telephone | 9076440442 |
| Authorized Official Credential | D.P.M. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
7766 | AK | Podiatric Medicine & Surgery Service Providers |
| Street Address |
4001 LAUREL ST SUITE 209 |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99508-5300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487643169 | Jann Lee Urban | Anesthesiology | 4001 Laurel St, Suite 202, Anchorage, AK 99508-5300 | 2005-10-17 |
| 1922495407 | Denali Asthma and Pulmonary, LLC | Internal Medicine | 4001 Laurel St, Suite 206, Anchorage, AK 99508-5300 | 2015-04-22 |
| 1144612714 | Anchorage Surgicenter, LLC | Clinic/Center | 4001 Laurel St, Suite A, Anchorage, AK 99508-5300 | 2015-02-19 |
| 1437407277 | Alyeska Vascular Surgery LLC | Surgery | 4001 Laurel St, Ste 204, Anchorage, AK 99508 | 2012-08-28 |
| 1265795983 | Urban Anesthesiology, P.c | Anesthesiology | 4001 Laurel St, Suite 202, Anchorage, AK 99508-5300 | 2012-06-18 |
| 1255604948 | New Frontier Anesthesia, LLC | Anesthesiology | 4001 Laurel St, Suite A, Anchorage, AK 99508-5300 | 2012-02-11 |
| 1801043013 | Zachary John Steiner | Surgery | 4001 Laurel St, Ste 204, Anchorage, AK 99508-5300 | 2008-08-19 |
| 1861674285 | David D Beal Md PC | Otolaryngology | 4001 Laurel St, Ste 204, Anchorage, AK 99508-5300 | 2007-11-27 |
| 1952521346 | Douglas J Luiten | Dentist | 4001 Laurel St, Suite 208, Anchorage, AK 99508-5332 | 2007-04-26 |
| 1508958521 | Lawrence Jedlicka | Internal Medicine | 4001 Laurel St, Anchorage, AK 99508-5300 | 2006-09-28 |
| 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 | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821135427 | Matt A Heilala | Podiatrist | 4100 Lake Otis Pkwy Ste 312, Anchorage, AK 99508-5231 | 2007-01-31 |
| 1588755110 | Kenneth Craig Swayman | Podiatrist | 2741 Debarr Rd Ste C315, Anchorage, AK 99508-2992 | 2006-09-27 |
| 1245656727 | Anchorage Foot and Ankle Clinic, LLC | Podiatrist | 1000 E Dimond Blvd, Suite 201, Anchorage, AK 99515-2029 | 2014-03-08 |
| 1447424965 | Jared Kern | Podiatrist | 4100 Lake Otis Pkwy, Suite 312, Anchorage, AK 99508-5229 | 2008-04-16 |
| 1891821534 | Gary H Wilson | Podiatrist | 1000 E Dimond Blvd, Anchorage, AK 99515-2008 | 2007-02-26 |
| 1255478863 | Jennifer Jansma | Podiatrist | 4100 Lake Otis Pkwy Ste 312, Anchorage, AK 99508-5231 | 2007-01-31 |
| 1457431785 | Karl Albert Boesenberg | Podiatrist | 2741 Debarr Rd, Suite C-315, Anchorage, AK 99508-2953 | 2006-10-17 |
| 1316046790 | Matt A. Heilala, Dpm Inc. | Podiatrist | 4100 Lake Otis Pkwy, Suite 312, Anchorage, AK 99508-5222 | 2006-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922566652 | Matt A. Heilala, Dpm Inc. | Podiatrist | 3190 E Meridian Park Loop Ste 205, Wasilla, AK 99654-7422 | 2019-03-12 |
| 1578819215 | Danny Romman | Podiatrist | 240 Hospital Pl Ste 203, Soldotna, AK 99669-7559 | 2012-07-31 |
| 1659687945 | Fairbanks Foot & Ankle Inc. | Podiatrist | 1405 Kellum St., Ste 200, Fairbanks, AK 99701 | 2010-08-24 |
| 1417042912 | Frank Fir Mesdag | Podiatrist | 8800 Glacier Highway, Suite 218, Juneau, AK 99801-8080 | 2006-10-03 |
| 1649620303 | Whitney Daneille Garner | Podiatrist | 673 Mdg, 5955 Zeamer Avenue, Jber, AK 99506 | 2016-06-14 |
| 1699119016 | Kristina Diann Lacy | Podiatrist | 240 Hospital Pl, Suite 203, Soldotna, AK 99669-7559 | 2013-04-29 |
| 1699968438 | Kito Daren Brooks | Podiatrist | 5955 Zeamer Ave, Jber, AK 99506-3702 | 2007-08-24 |
| 1669673596 | Kelly Marie Moxley | Podiatrist | 8800 Glacier Hwy, Suite 218, Juneau, AK 99801-8087 | 2007-05-29 |
| 1720041601 | Brett Carner | Podiatrist | 5955 Zeamer Avenue, 673d Mdg, Jber, AK 99506 | 2006-04-11 |
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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.