MR. CHRISTOPHER DAVID DIETRICH (NPI# 1962890939) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962890939 |
| Entity Type | Individual |
| Full Name | MR. CHRISTOPHER DAVID DIETRICH |
| Credential | PA-C |
| Practice Address |
17025 Snowmobile Ln Eagle River AK 99577-7044 |
| Practice Telephone | 9076967466 |
| Mailing Telephone | 9076967466 |
| Enumeration Date | 2014-12-29 |
| Last Update Date | 2015-03-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
2393 | AK | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | 1626073 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750900692 | Christopher Dietrich | Physical Therapist | 804 State St Unit 5, Quincy, IL 62301-4968 | 2020-04-10 |
| 1578000881 | Christopher Dietrich | Behavior Technician | 800 Ferrari, Suite 100, Ontario, CA 91764-5030 | 2017-01-24 |
| 1356887756 | Christopher Dietrich | Marriage & Family Therapist | 712 S Center St, Reno, NV 89501-2304 | 2017-01-10 |
| 1871988774 | Christopher Dietrich | Internal Medicine | 2800 10th Ave N, Billings, MT 59101-0703 | 2015-03-30 |
| 1013967462 | Christopher Wayne Dietrich | Physician Assistant | 8333 Naab Rd, Suite 250, Indianapolis, IN 46260-5924 | 2006-05-10 |
| 1063403905 | Christopher T Dietrich | Physical Medicine & Rehabilitation | 1136 Jackson Blvd, Rapid City, SD 57702-4335 | 2005-10-31 |
| Street Address |
17025 SNOWMOBILE LN |
| City | EAGLE RIVER |
| State | AK |
| Zip Code | 99577-7044 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518958396 | Heather Mcneal Jones | Family Medicine | 17025 Snowmobile Ln, Eagle River, AK 99577-7044 | 2005-11-02 |
| 1669924395 | Medical Group of Alaska | Family Medicine | 17025 Snowmobile Ln, Eagle River, AK 99577-7044 | 2016-10-28 |
| 1205283561 | Carly Lynn Thomas | Physician Assistant | 17025 Snowmobile Ln, Eagle River, AK 99577-7044 | 2016-05-17 |
| 1548627680 | Kaila Hayes | Registered Nurse | 17025 Snowmobile Ln, Eagle River, AK 99577-7044 | 2016-01-20 |
| 1306221544 | Aurora Sidney-ando | Counselor | 17025 Snowmobile Ln, Suite 4, Eagle River, AK 99577-7044 | 2015-07-29 |
| 1770981425 | Cherise Hug | Physician Assistant | 17025 Snowmobile Ln, Suite 4, Eagle River, AK 99577-7044 | 2014-12-11 |
| 1043610892 | Orion Behavioral Health Network | Psychologist | 17025 Snowmobile Ln, Suite 4, Eagle River, AK 99577-7044 | 2014-08-29 |
| 1154768323 | Leska Nicole James | Nurse Practitioner | 17025 Snowmobile Ln, Eagle River, AK 99577-7044 | 2013-05-29 |
| 1902150139 | Kerry A Anson | Physician Assistant | 17025 Snowmobile Ln, Eagle River, AK 99577-7044 | 2012-11-09 |
| 1265702997 | Orion Behavioral Health Network, LLC | Pediatrics | 17025 Snowmobile Ln, Suite 4, Eagle River, AK 99577-7044 | 2012-01-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831758333 | Dianne E Lyons | Behavior Technician | 16331 Heritage Place, Suite 101, Eagle River, AK 99577 | 2019-06-07 |
| 1073007209 | Center for Natural Medicine, Inc. | Acupuncturist | 16844 Easy St, Eagle River, AK 99577 | 2018-06-20 |
| 1538652748 | Shelly Rana Budde | Nurse Practitioner | 19139 Upper Skyline Dr, Eagle River, AK 99577 | 2018-06-12 |
| 1700387529 | Aaron Wesley Jones | Behavior Technician | 16941 Notrh Eagle River Loop Road, Eagle River, Ak, AK 99577 | 2018-02-27 |
| 1033641881 | Sierra Bracken | Massage Therapist | 12812 Old Glenn Hwy, Ste C3, Eagle River, AK 99577 | 2017-03-31 |
| 1699213231 | Jolene Denee Rogers | Counselor | 13620 Old Glenn Hwy, Ste C, Eagle River, AK 99577 | 2017-02-02 |
| 1881040962 | Elizabeth Hanson | Behavioral Analyst | 16941 North Eagle River Loop Road, Suite 3, Eagle River, AK 99577 | 2016-05-09 |
| 1023496148 | Joel Richard Wallace | Dentist | 16727 Farm Avenue, Eagle River, AK 99577 | 2015-05-08 |
| 1184019663 | Nicole Christine Newman | Physician Assistant | 11432 Business Blvd., Suite 4, Eagle River, AK 99577 | 2015-04-01 |
| 1417365362 | Tammi Smith | Community Health Worker | 16510 Centerfield Dr B 107, Eagle River, AK 99577 | 2014-07-23 |
| Find all providers in zip 99577 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780184929 | Richard Rodd Wehling | Physician Assistant | 18226 Meadow Creek Dr, Eagle River, AK 99577-8252 | 2018-02-14 |
| 1336270347 | John Andrew Winczura | Physician Assistant | 1444 S Creek Rd, Eagle River, AK 99577-9461 | 2007-03-08 |
| 1902150139 | Kerry A Anson | Physician Assistant | 17025 Snowmobile Ln, Eagle River, AK 99577-7044 | 2012-11-09 |
| 1376835355 | Meadow Creek Healthcare LLC | Physician Assistant | 16839 Park Place St, Same, Eagle River, AK 99577-7819 | 2011-05-09 |
| 1235319450 | Eagle River Primary Care | Physician Assistant | 11462 Business Blvd, Eagle River, AK 99577-7721 | 2007-11-05 |
| 1033248786 | Cheryl K Fitzgerald | Physician Assistant | 16839 Park Place St, Eagle River, AK 99577-7819 | 2007-03-05 |
| 1881750537 | Harry H Whidden | Physician Assistant | 150 Hospital Rd, Eagle River, WI 54521-8877 | 2006-12-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922634047 | Chelsie Coffman | Physician Assistant | 7300 Klawock Hollis Hwy A, Klawock, AK 99925 | 2020-03-20 |
| 1912549098 | Craig Michael Brumagin | Physician Assistant | 4961 E Mayflower Ln, Wasilla, AK 99654-7708 | 2019-10-10 |
| 1801314596 | Sara Breann Langford | Physician Assistant | 575 Riverstone Way Unit 1, Fairbanks, AK 99709-2939 | 2017-09-01 |
| 1528503687 | Northwoods Family Medicine, Inc | Physician Assistant | 1301 E. Palmer-wasilla Hwy, #400, Wasilla, AK 99654 | 2016-12-28 |
| 1972980639 | Jesika Harrell | Physician Assistant | 500 East Benson Blvd, Suite 103, Anchorage, AK 99623 | 2015-05-01 |
| 1770977571 | Audrey Christine Kelley | Physician Assistant | 9150 Jewel Lake Rd # B, Anchorage, AK 99502-5381 | 2015-03-19 |
| 1851799027 | Jennifer Anne Fayette | Physician Assistant | 2741 Debarr Rd Ste C302, Anchorage, AK 99508-2972 | 2014-12-19 |
| 1669898474 | Louis Michael Smith | Physician Assistant | 22301 W Alsop Rd, Wasilla, AK 99623-5023 | 2014-03-17 |
| 1033451703 | Allison Cooper | Physician Assistant | 2310 Peger Rd Suite 105, Fairbanks, AK 99709-4848 | 2013-03-20 |
| 1053667956 | Heather Cherie Pollard | Physician Assistant | 4000 Ambassador Drive, Chap Training, Anchorage, AK 99508 | 2012-07-28 |
| Find all providers with the same taxonomy | ||||
| City | EAGLE RIVER |
| Zip Code | 99577 |
Please comment or provide details below to improve the information on MR. CHRISTOPHER DAVID DIETRICH.
| 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.