BRODRIK DONALD RIVERS (NPI# 1902410178) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902410178 |
| Entity Type | Individual |
| Full Name | BRODRIK DONALD RIVERS |
| Practice Address |
1401 S Seward Meridian Pkwy Ste Ab Wasilla AK 99654-8312 |
| Practice Telephone | 9076313520 |
| Mailing Telephone | 9076313520 |
| Enumeration Date | 2020-09-03 |
| Last Update Date | 2020-09-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 385H00000X | Respite Care | Respite Care Facility |
| Street Address |
1401 S SEWARD MERIDIAN PKWY STE AB |
| City | WASILLA |
| State | AK |
| Zip Code | 99654-8312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437774668 | Autum Lynn Vigdahl | Technician | 1401 S Seward Meridian Pkwy Ste Ab, Wasilla, AK 99654-8312 | 2020-06-12 |
| 1255930335 | Amanda Marie Fedewa | Technician | 1401 S Seward Meridian Pkwy Ste Ab, Wasilla, AK 99654-8312 | 2020-10-20 |
| 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 | 385H00000X |
| Grouping | Respite Care Facility |
| Classification | Respite Care |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467696641 | Wasilla Retirement, LLC | Respite Care | 889 N. Elkhorn Drive, Wasilla, AK 99654 | 2009-05-01 |
| 1881865921 | Trinion Quality Care Services, Inc | Respite Care | 1375 E Parks Hwy, Ste D-4, Wasilla, AK 99654-8288 | 2008-03-17 |
| 1043454408 | Nataliyas Care Services | Respite Care | 1450 N Creste Foris St Ste A, Wasilla, AK 99654-5651 | 2009-04-28 |
| 1679697783 | 5-d Corporation | Respite Care | 2800 N Lagoon Dr., Wasilla, AK 99654 | 2007-03-16 |
| 1144359142 | Northern Living Centers, LLC | Respite Care | 2795 W Stonebridge Dr, Wasilla, AK 99654-0742 | 2007-03-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225668718 | Turnagain Assisted Living LLC. | Respite Care | 3406 Seppala Dr Unit B, Anchorage, AK 99517-1143 | 2020-01-23 |
| 1518500297 | Lamin St Jammeh | Respite Care | 7924 Parkway Dr, Anchorage, AK 99504-2840 | 2019-10-24 |
| 1548744469 | Independence Lodge, LLC | Respite Care | 6941 Stanley Dr, Anchorage, AK 99518-2163 | 2018-09-17 |
| 1255769899 | A Loving Care PCa | Respite Care | 343 W Benson Blvd Ste 4, Anchorage, AK 99503-3950 | 2013-10-17 |
| 1619244548 | A Kodiak Welcome Bed and Breakfast | Respite Care | 3570 Sean Circle, Kodiak, AK 99615 | 2011-11-21 |
| 1528358207 | Divine Mercy II Alh, LLC | Respite Care | 417 E 11th Ave Apt 5, Anchorage, AK 99501-4560 | 2011-04-14 |
| 1659601409 | Northern Lighthouse Dba Northern Lighthouse Day Center | Respite Care | 136 E Redoubt Ave, Soldotna, AK 99669-8012 | 2009-12-29 |
| 1952534489 | The Ark of Homer | Respite Care | 1136 Seabreeze Ct, Homer, AK 99603-7935 | 2009-09-01 |
| 1780855791 | Trinion Quality Care Services, Inc | Respite Care | 909 Delapp Road, Bethel, AK 99559 | 2008-03-18 |
| 1396913307 | Fernridge Tlc | Respite Care | 40811 Mclay Road, Homer, AK 99603 | 2008-02-12 |
| 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.