MEDICAL GROUP OF ALASKA (NPI# 1013469741) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013469741 |
| Entity Type | Organization |
| Organization Name | MEDICAL GROUP OF ALASKA |
| Other Organization Name | CAPSTONE URGENT CARE, WASILLA |
| Practice Address |
3066 E Meridian Park Loop Wasilla AK 99654-7254 |
| Mailing Address |
3122 E Meridian Park Loop Wasilla AK 99654-7255 |
| Practice Telephone | 9073579560 |
| Practice Fax Number | 9073579596 |
| Mailing Telephone | 9073579590 |
| Mailing Fax Number | 9073579593 |
| Enumeration Date | 2016-10-28 |
| Last Update Date | 2016-10-28 |
| Authorized Official Name | WADE S ERICKSON (OWNER) |
| Authorized Official Telephone | 9073579590 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDICAL GROUP OF ALASKA, LLC |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
1019166 | AK | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | MEDICARE PTAN | K167625 | 01 |
| Other Name | Type Code |
|---|---|
| Capstone Urgent Care, Wasilla | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588116909 | Medical Group of Alaska | Clinic/Center | 3190 E Meridian Park Loop, 206a, Wasilla, AK 99654-7422 | 2016-11-02 |
| 1750730594 | Medical Group of Alaska | General Practice | 3190 E Meridian Park Loop Ste 207, Wasilla, AK 99654-7422 | 2016-06-10 |
| 1669907606 | Medical Group of Alaska | Clinic/Center | 3190 E Meridian Park Loop, Suite 206b, Wasilla, AK 99654-7422 | 2017-04-27 |
| 1023560752 | Medical Group of Alaska | Family Medicine | 3122 E Meridian Park Loop, Wasilla, AK 99654-7255 | 2016-10-28 |
| 1669924395 | Medical Group of Alaska | Family Medicine | 17025 Snowmobile Ln, Eagle River, AK 99577-7044 | 2016-10-28 |
| Street Address |
3066 E MERIDIAN PARK LOOP |
| City | WASILLA |
| State | AK |
| Zip Code | 99654-7254 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427049238 | Scott William Schafer | Physician Assistant | 3066 E Meridian Park Loop, Capstone Urgent Care, Wasilla, AK 99654-7372 | 2005-11-01 |
| 1023404738 | Capstone Urgent Care LLC | Non-Pharmacy Dispensing Site | 3066 E Meridian Park Loop, Wasilla, AK 99654-7372 | 2015-04-09 |
| 1578953253 | Capstone Urgent Care LLC | Non-Pharmacy Dispensing Site | 3066 E Meridian Park Loop, Wasilla, AK 99654-7372 | 2015-02-02 |
| 1508287467 | Megan Joelle Larson | Physician Assistant | 3066 E Meridian Park Loop, Wasilla, AK 99654-7372 | 2013-12-19 |
| 1538414834 | Medical Network of Alaska, LLC | Clinic/Center | 3066 E Meridian Park Loop, Suite 2, Wasilla, AK 99654 | 2012-07-23 |
| 1073872669 | Lynx Medical Services Organization | Phlebology | 3066 E Meridian Park Loop, Wasilla, AK 99654-7299 | 2012-05-16 |
| 1790044592 | Lynx Medical Services Organization | Family Medicine | 3066 E Meridian Park Loop, Wasilla, AK 99654-7299 | 2012-05-14 |
| 1609176783 | Algone Center | Pain Medicine | 3066 E Meridian Park Loop, #1, Wasilla, AK 99654-7299 | 2010-10-23 |
| 1184938813 | Karen Ruckle Gardner | Nurse Practitioner | 3066 E Meridian Park Loop, Wasilla, AK 99654-7299 | 2010-08-05 |
| 1790964195 | Jessica J Jachimiec | Family Medicine | 3066 E Meridian Park Loop, Wasilla, AK 99654-7299 | 2007-11-01 |
| Find all providers in the same location | ||||
| 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 | 261QU0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Urgent Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861935975 | Mat-su Valley IIi LLC | Clinic/Center | 5851 South Knik-goose Bay Road, Wasilla, AK 99623 | 2016-11-21 |
| 1275587768 | Urgent Care At Lake Lucille Inc | Clinic/Center | 185 E Parks Hwy, Wasilla, AK 99654-7038 | 2006-05-20 |
| 1538414834 | Medical Network of Alaska, LLC | Clinic/Center | 3066 E Meridian Park Loop, Suite 2, Wasilla, AK 99654 | 2012-07-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720614993 | Peninsula Instacare | Clinic/Center | 34581 Kenai Spur Hwy, Suite 1, Soldotna, AK 99669 | 2020-03-19 |
| 1588207179 | Central Peninsula General Hospital, Inc | Clinic/Center | 10128 Kenai Spur Hwy, Kenai, AK 99611-7807 | 2019-10-25 |
| 1003339334 | Kenai Peninsula Health System LLC Urgent Care of Soldotna | Clinic/Center | 44604 Sterling Hwy Ste D, Soldotna, AK 99669-7962 | 2017-07-19 |
| 1710358809 | Anchorage Medical Services, Inc | Clinic/Center | 3401 Minnesota Dr Ste 100, Anchorage, AK 99503-3684 | 2015-10-14 |
| 1770724510 | Horizon Medical, Inc | Clinic/Center | 238.8 Parks Highway, Denali Park, AK 99755 | 2009-03-06 |
| 1366596504 | Kodiak Island Ambulatory Care Clinic Inc. | Clinic/Center | 202 Center Ave, Ste. 102, Kodiak, AK 99615-1126 | 2007-01-23 |
| 1578655213 | First Care Medical Centers LLC | Clinic/Center | 1301 Huffman Rd, Suite 100, Anchorage, AK 99515-3568 | 2006-09-29 |
| 1609871391 | Cross Road Health Ministries, Inc. | Clinic/Center | Mile 187 Glenn Highway, Glennallen, AK 99588-0589 | 2005-06-17 |
| 1306484332 | Urgent Care of Soldotna Inc. | Clinic/Center | 44604 Sterling Hwy Ste D, Soldotna, AK 99669-7962 | 2019-12-20 |
| 1518472984 | Mat-su Valley IIi LLC | Clinic/Center | 209 W Evergreen Ave, Palmer, AK 99645-6952 | 2017-12-07 |
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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.