| Independence Park Medical Services Inc | |
|
9500 Independence Dr Ste 900 Anchorage AK 99507-4615 | |
| (907) 522-1341 | |
| (907) 522-1343 |
| Full Name | Independence Park Medical Services Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 9500 Independence Dr, Anchorage, Alaska |
| Authorized Official Name and Position | Helen R Spencer (CLINIC MANAGER) |
| Authorized Official Contact | 9075221342 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Independence Park Medical Services Inc 9500 Independence Dr Ste 900 Anchorage AK 99507-4615 Ph: (907) 522-1341 | Independence Park Medical Services Inc 9500 Independence Dr Ste 900 Anchorage AK 99507-4615 Ph: (907) 522-1341 |
| NPI Number | 1366435273 |
|---|---|
| Provider Enumeration Date | 08/25/2005 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 9032018528 |
|---|---|
| Medicare Enrollment ID | O20040105000130 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366435273 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Ernest J Meinhardt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699768598 PECOS PAC ID: 5092614594 Enrollment ID: I20050926000412 |
| Provider Name | Cydney Fenton |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1497788921 PECOS PAC ID: 4385675909 Enrollment ID: I20151005000890 |
| Provider Name | Bradford W Fenton |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1891750568 PECOS PAC ID: 7214966258 Enrollment ID: I20160323001623 |
| Provider Name | Pebbles D Shanley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962842260 PECOS PAC ID: 2961632815 Enrollment ID: I20160624000675 |
| Provider Name | Kathryn A Ryan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629418215 PECOS PAC ID: 4385873249 Enrollment ID: I20161031000476 |
| Provider Name | Natasha Renae Sherrill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609380385 PECOS PAC ID: 0547518649 Enrollment ID: I20180807000415 |
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