WASILLA INTERNAL MEDICINE LLC


Address: 3719 E Meridian Loop Ste F, Wasilla, AK 99654-7273
Phone: 9073735940

WASILLA INTERNAL MEDICINE LLC (NPI# 1578110011) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1578110011
Entity Type Organization
Organization Name WASILLA INTERNAL MEDICINE LLC
Practice Address 3719 E Meridian Loop Ste F
Wasilla
AK 99654-7273
Practice Telephone 9073735940
Practice Fax Number 9073735947
Mailing Telephone 9073735940
Mailing Fax Number 9073735947
Enumeration Date 2019-08-20
Last Update Date 2019-08-20
Authorized Official Name METTESSA MAYE REID (ADMINISTRATOR)
Authorized Official Telephone 9072503482
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207Q00000X Family Medicine Allopathic & Osteopathic Physicians
Y 207R00000X Internal Medicine Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
AK MD5445 05

Office Location

Street Address 3719 E MERIDIAN LOOP STE F
City WASILLA
State AK
Zip Code 99654-7273

Providers in the same location

NPI Name Taxonomy Address Enumeration
1912343815 Michelle Ann Rountree Registered Nurse 3719 E Meridian Loop Ste F, Wasilla, AK 99654-7273 2013-05-17

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 207R00000X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine

Taxonomy Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1427133958 Partners In Health Medical Clinic Internal Medicine 472 N Main St, Suite B, Wasilla, AK 99654-7018 2006-10-25
1861437311 John D Hunter Internal Medicine 1751 Gardner Way, Ste D, Wasilla, AK 99654-6513 2006-06-18
1164479374 Loetta Mae Horswill-woods Internal Medicine 3719 E Meridian Loop, Suite F, Wasilla, AK 99654-7270 2006-05-31
1124081211 David Barnes Internal Medicine 3719 E Meridian Loop Ste A, Wasilla, AK 99654-7273 2006-04-10
1699734673 Richard J Zajac Internal Medicine 950 Bogard Rd, 207, Wasilla, AK 99654-7105 2006-03-20
1134523855 Cottonwood Creek Clinic LLC Internal Medicine 3600 E Wickersham Way, Wasilla, AK 99654-7550 2014-10-09
1316289176 John D Hunter, Md Inc Internal Medicine 1751 E Gardner Way, Ste D, Wasilla, AK 99654-6564 2013-03-20
1962705202 Heritage Medical Group LLC Internal Medicine 501 N Knik St, Wasilla, AK 99654-7050 2010-12-08
1366752560 Mat-su Valley IIi LLC Internal Medicine 950 E Bogard Rd, Suite 207, Wasilla, AK 99654-7184 2010-10-21
1841405883 Carole Suzanne Ruegsegger Internal Medicine 3750 E Country Field Cir, Unit B, Wasilla, AK 99654-6689 2007-05-12
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City WASILLA
Zip Code 99654

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Dataset Information

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.

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