MAT-SU COMMUNITY PEDIATRICS, P.C. (NPI# 1003142621) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003142621 |
| Entity Type | Organization |
| Organization Name | MAT-SU COMMUNITY PEDIATRICS, P.C. |
| Practice Address |
3750 E. Country Field Circle Suite C Wasilla AK 99654 |
| Practice Telephone | 9073572955 |
| Practice Fax Number | 9073579348 |
| Mailing Telephone | 9073572955 |
| Mailing Fax Number | 9073579348 |
| Enumeration Date | 2009-11-02 |
| Last Update Date | 2009-11-02 |
| Authorized Official Name | DR. TAMARA M KRIMM (PRESIDENT/CHIEF MEDICAL OFFICER) |
| Authorized Official Telephone | 9073572955 |
| Authorized Official Credential | M.D., F.A.A.P. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Street Address |
3750 E. COUNTRY FIELD CIRCLE SUITE C |
| City | WASILLA |
| State | AK |
| Zip Code | 99654 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831602341 | Desiree Dawn Cook | Nurse Practitioner | 3750 E. Country Field Circle, Suite C, Wasilla, AK 99654 | 2017-11-07 |
| 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 | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164502829 | Tamara M Krimm | Pediatrics | 3750 E Country Field Circle, C, Wasilla, AK 99654 | 2006-10-17 |
| 1831188473 | Laura Jean Peterson | Pediatrics | 950 E Bogard Rd, Ste 233, Wasilla, AK 99654-7184 | 2005-10-17 |
| 1811359896 | Alexandria Paige Boley | Pediatrics | 1001 S Knik Goose Bay Rd, Wasilla, AK 99654-8083 | 2016-03-28 |
| 1588915755 | Alaska Pediatrics Associates PC | Pediatrics | 5050 E Dunbar Dr, Suite F, Wasilla, AK 99654-7758 | 2012-09-27 |
| 1326306150 | Adventures In Pediatrics, LLC | Pediatrics | 3719 E Meridian Loop, Suite D, Wasilla, AK 99654-7273 | 2012-04-30 |
| 1053574293 | Ptarmigan Pediatrics LLC | Pediatrics | 950 E Bogard Rd, Suite 233, Wasilla, AK 99654-7184 | 2008-07-08 |
| 1427167113 | Karen Dyan Impson | Pediatrics | 3719 E Meridian Loop, Suite D, Wasilla, AK 99654-7270 | 2006-08-29 |
| 1568476596 | Elowyn M Smith | Pediatrics | 950 E Bogard Rd, Suite 233, Wasilla, AK 99654-7184 | 2006-07-27 |
| 1093790628 | Bruce Wayne Hess | Pediatrics | 950 E Bogard Rd, Suite 233, Wasilla, AK 99654-7184 | 2005-12-06 |
| 1699765347 | Marie Westphal | Pediatrics | 950 E Bogard Rd, Wasilla, AK 99654-7184 | 2005-10-25 |
| Find all providers in WASILLA | ||||
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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.