LA MAESTRA FAMILY CLINIC, INC. (NPI# 1912301110) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912301110 |
| Entity Type | Organization |
| Organization Name | LA MAESTRA FAMILY CLINIC, INC. |
| Other Organization Name | LA MAESTRA SELDOVIA CLINIC |
| Practice Address |
259 Seldovia Street Box 206 Seldovia AK 99663-0206 |
| Mailing Address |
4060 Fairmount Ave San Diego CA 92105-1608 |
| Practice Telephone | 9072347825 |
| Practice Fax Number | 9072347825 |
| Mailing Telephone | 6195841612 |
| Mailing Fax Number | 6192816738 |
| Enumeration Date | 2014-10-16 |
| Last Update Date | 2016-09-01 |
| Authorized Official Name | TOM VU (DIRECTOR OF CORPORATE COMPLIANCE) |
| Authorized Official Telephone | 6192691292 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 1011073 | AK | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | 1011073 | AK | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| La Maestra Seldovia Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326578774 | La Maestra Family Clinic, Inc. | Pharmacy | 165 S 1st St Ste 1b, El Cajon, CA 92019-4795 | 2017-06-19 |
| 1265831960 | La Maestra Family Clinic, Inc. | Clinic/Center | 4171 Fairmount Ave, San Diego, CA 92105-1609 | 2014-08-19 |
| 1508949645 | La Maestra Family Clinic, Inc. | Clinic/Center | 217 Highland Avenue, National City, CA 91950 | 2006-10-23 |
| 1073177739 | La Maestra Family Clinic, Inc. | Clinic/Center | 4060 Fairmount Ave, San Diego, CA 92105-1608 | 2019-04-29 |
| 1467950550 | La Maestra Family Clinic, Inc. | Pharmacy | 209 Highland Ave, National City, CA 91950-1518 | 2018-01-24 |
| 1467718791 | La Maestra Family Clinic, Inc. | Clinic/Center | 4060 Fairmount Ave, San Diego, CA 92105-1608 | 2012-04-11 |
| 1891011599 | La Maestra Family Clinic, Inc. | Clinic/Center | 7967 Broadway, Lemon Grove, CA 91945-1809 | 2010-04-20 |
| 1609849074 | La Maestra Family Clinic, Inc. | Clinic/Center | 4060 Fairmount Ave, San Diego, CA 92105-1608 | 2006-02-08 |
| Street Address |
259 SELDOVIA STREET, BOX 206 |
| City | SELDOVIA |
| State | AK |
| Zip Code | 99663-0206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184174831 | Community Health Imaging Centers | Clinic/Center | 259 Seldovia Street, Seldovia, AK 99663 | 2016-10-06 |
| 1699166215 | Alison Godwin | Massage Therapist | 206 Main Street, Seldovia, AK 99663 | 2015-02-18 |
| 1417020348 | Lawrence Lewis Reynolds | General Practice | 252 Seldovia St, Seldovia, AK 99663-0210 | 2006-11-16 |
| 1790773570 | Mary Anne Wilson | Nurse Practitioner | 319 Eagle Run Loop, Box 215, Seldovia, AK 99663-0215 | 2005-10-06 |
| 1487989117 | Lilli Ann Ohse | Counselor | Po Box L, Seldovia, AK 99663-0250 | 2009-10-14 |
| 1093272148 | Melissa R Peterson | Dental Hygienist | Po Box L, Seldovia, AK 99663-0250 | 2019-02-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184174831 | Community Health Imaging Centers | Clinic/Center | 259 Seldovia Street, Seldovia, AK 99663 | 2016-10-06 |
| 1487989117 | Lilli Ann Ohse | Counselor | Po Box L, Seldovia, AK 99663-0250 | 2009-10-14 |
| 1417020348 | Lawrence Lewis Reynolds | General Practice | 252 Seldovia St, Seldovia, AK 99663-0210 | 2006-11-16 |
| 1790773570 | Mary Anne Wilson | Nurse Practitioner | 319 Eagle Run Loop, Box 215, Seldovia, AK 99663-0215 | 2005-10-06 |
| 1093272148 | Melissa R Peterson | Dental Hygienist | Po Box L, Seldovia, AK 99663-0250 | 2019-02-25 |
| 1699166215 | Alison Godwin | Massage Therapist | 206 Main Street, Seldovia, AK 99663 | 2015-02-18 |
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
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| 1831702455 | Dr. Bart Worthington LLC | Family Medicine | 2957 Santa Patricia Ct, North Pole, AK 99705-6138 | 2020-08-24 |
| 1861015562 | Maria L Freeman | Family Medicine | 1261 S Seward Meridian Pkwy Ste A, Wasilla, AK 99654-8372 | 2020-05-28 |
| 1285265181 | Kodiak Birth and Wellness, LLC | Family Medicine | 1527 Mission Rd, Kodiak, AK 99615-6507 | 2020-01-29 |
| 1104487461 | The Alfa Doc LLC | Family Medicine | 154 Fairbanks Drive, Valdez, AK 99686 | 2019-06-26 |
| 1982176368 | Functional Medicine of Alaska, LLC | Family Medicine | 508 S Willow St Ste C, Kenai, AK 99611-6940 | 2018-12-22 |
| 1639645021 | Alaska Medical Specialty Group LLC | Family Medicine | 4100 Lake Otis Pkwy Ste 218, Anchorage, AK 99508-5230 | 2018-10-23 |
| 1447736491 | John Martin Kinsey | Family Medicine | 509 Pine Ave, Kenai, AK 99611-7556 | 2018-07-12 |
| 1790278356 | Vanity: Aesthetics, Dermatology & Wellness, LLC | Family Medicine | 431 W 7th Ave Ste 204, Anchorage, AK 99501-3500 | 2018-06-08 |
| 1134638141 | Nathan Neves George | Family Medicine | 950 E Bogard Rd Ste 228, Wasilla, AK 99654-7185 | 2017-09-21 |
| 1396275632 | Donald Curran Olson | Family Medicine | Po Box 62119, Golovin, AK 99762-6119 | 2017-06-19 |
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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.