TREVOR DALE MUNGER (NPI# 1962761973) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962761973 |
| Entity Type | Individual |
| Full Name | TREVOR DALE MUNGER |
| Credential | CPO |
| Practice Address |
1700 E Bogard Rd Ste 104 Building B Wasilla AK 99654-6563 |
| Mailing Address |
5701 Lake Otis Pkwy Ste 400 Anchorage AK 99507-1778 |
| Practice Telephone | 9077439991 |
| Practice Fax Number | 9077439992 |
| Mailing Telephone | 9077439991 |
| Mailing Fax Number | 9077439992 |
| Enumeration Date | 2012-05-10 |
| Last Update Date | 2012-05-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 222Z00000X | Orthotist | CPO01700 | DE | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 224P00000X | Prosthetist | CPO01700 | DE | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 224L00000X | Pedorthist | CPO01700 | DE | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1700 E BOGARD RD STE 104 BUILDING B |
| City | WASILLA |
| State | AK |
| Zip Code | 99654-6563 |
| 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 | 222Z00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Orthotist |
| A health care professional who is specifically educated and trained to manage comprehensive orthotic patient care, including musculoskeletal and neuromuscular anomalies resulting from injuries or disease processes involving the lower extremity, upper extremity or spinal segment/s and positional deformation of the cranium. Orthotists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952445041 | Northern Orthopedics Inc | Orthotist | 3719 E Meridian Loop, Suite H, Wasilla, AK 99654-7273 | 2007-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235632654 | Seth Eric Mclarty | Orthotist | 3400 Latouche St # 100, Anchorage, AK 99508 | 2018-03-12 |
| 1992992309 | Eric Clifford O'guinn | Orthotist | 215 N Fireweed St, Soldotna, AK 99669-7540 | 2007-09-29 |
| 1578783411 | William C Sundberg | Orthotist | 12201 Industry Way, Suite D1, Anchorage, AK 99515-4316 | 2007-04-25 |
| 1649314725 | Dana Marie Klaameyer | Orthotist | 3400 Latouche St, Suite 100, Anchorage, AK 99508-4208 | 2007-02-20 |
| 1184716649 | Elizabeth Einset | Orthotist | 5193 Borch St N, Ketchikan, AK 99901-9036 | 2006-09-29 |
| 1700377355 | Erin Danielle Morgan | Orthotist | 3400 Latouche St # 100, Anchorage, AK 99508-4208 | 2018-05-18 |
| 1932649670 | Caitlin Menge | Orthotist | 3400 Latouche St, Ste. 100, Anchorage, AK 99508-4208 | 2017-02-28 |
| 1497196265 | Raymond Francis Gilligan Jr. | Orthotist | 3517 Industrial Ave, Fairbanks, AK 99701-7377 | 2013-07-09 |
| 1235480385 | Gretchen Renee Wellman | Orthotist | 3400 Latouche St, Suite 100, Anchorage, AK 99508-4208 | 2012-09-28 |
| 1699819789 | Northern Orthopedics Inc | Orthotist | 3400 Latouche St, Suite 100, Anchorage, AK 99508-4208 | 2007-02-20 |
| 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.