| Providence Urgent Care | |
|
1200 W Northern Lights Blvd Ste B Anchorage AK 99503-3652 | |
| (907) 212-5165 | |
| Not Available |
| Full Name | Providence Urgent Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 1200 W Northern Lights Blvd Ste B, Anchorage, Alaska |
| Authorized Official Name and Position | Donald W. Anderson (ASSISTANT SECRETARY OF ENROLLMENTS) |
| Authorized Official Contact | 4255255392 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Urgent Care Po Box 5608 Portland OR 97228-5608 Ph: (888) 227-3312 | Providence Urgent Care 1200 W Northern Lights Blvd Ste B Anchorage AK 99503-3652 Ph: (907) 212-5165 |
| NPI Number | 1770244568 |
|---|---|
| Provider Enumeration Date | 01/04/2022 |
| Last Update Date | 10/11/2024 |
| Medicare PECOS PAC ID | 2163855032 |
|---|---|
| Medicare Enrollment ID | O20191206000950 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770244568 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Primary |
| Provider Name | Laura J Johnston |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609972231 PECOS PAC ID: 5991720716 Enrollment ID: I20051011000819 |
| Provider Name | Norvin Perez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1346235819 PECOS PAC ID: 9739120189 Enrollment ID: I20061120000604 |
| Provider Name | Stacey Vance |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952300790 PECOS PAC ID: 2860496965 Enrollment ID: I20101103000742 |
| Provider Name | Angela Marie Kuiper Santiago |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578997391 PECOS PAC ID: 0648493130 Enrollment ID: I20140602002230 |
| Provider Name | Karen Sallee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780874602 PECOS PAC ID: 1153353222 Enrollment ID: I20150812008775 |
| Provider Name | Pennie Schuh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568991305 PECOS PAC ID: 3274896725 Enrollment ID: I20180413001648 |
| Provider Name | Marion A Ruth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740789288 PECOS PAC ID: 3678817731 Enrollment ID: I20190820003864 |
| Provider Name | Cynthia Ramsey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003872789 PECOS PAC ID: 5395820864 Enrollment ID: I20210305001061 |
| Provider Name | Bella Orbino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710199427 PECOS PAC ID: 4082713946 Enrollment ID: I20210518003083 |
| Provider Name | Lara Jesic Lawlor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518089572 PECOS PAC ID: 6103924329 Enrollment ID: I20210915003671 |
| Provider Name | Jebb Sagun |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235783457 PECOS PAC ID: 9436481439 Enrollment ID: I20211103001758 |
| Provider Name | Olubanke Babalola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013329002 PECOS PAC ID: 9133345275 Enrollment ID: I20220421001831 |
| Provider Name | Denise Diep Thi Tran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922443266 PECOS PAC ID: 0749411486 Enrollment ID: I20230113001716 |
| Provider Name | Lovely Paul |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376852350 PECOS PAC ID: 9335337211 Enrollment ID: I20230605001828 |
| Provider Name | Tara Gonzales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700262763 PECOS PAC ID: 6507175734 Enrollment ID: I20230901001244 |
| Provider Name | Crystal Anne Sharon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326277013 PECOS PAC ID: 0446423917 Enrollment ID: I20230912002384 |
| Provider Name | Jacqueline Sammons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235539594 PECOS PAC ID: 1052636628 Enrollment ID: I20230928003348 |
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