ALASKA KIDNEY & DIABETES ASSOCIATION (NPI# 1619935558) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619935558 |
| Entity Type | Organization |
| Organization Name | ALASKA KIDNEY & DIABETES ASSOCIATION |
| Other Organization Name | BONGO MEDICAL |
| Practice Address |
3260 Providence Dr #523 Anchorage AK 99508-4608 |
| Practice Telephone | 9075691049 |
| Practice Fax Number | 9075634564 |
| Mailing Telephone | 9075691049 |
| Mailing Fax Number | 9075634564 |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2013-01-03 |
| Authorized Official Name | DR. LESLIE A. GLASGOW (CEO) |
| Authorized Official Telephone | 9075691049 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians | ||
| Y | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Bongo Medical | Other Name - Individual/Organization |
| Street Address |
3260 PROVIDENCE DR #523 |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99508-4608 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407854052 | Peter B Hulman | Internal Medicine | 3260 Providence Dr, Suite 431, Anchorage, AK 99508-4661 | 2005-07-08 |
| 1679920896 | Juliana Santillanes | Massage Therapist | 3260 Providence Dr, Suite 425, Anchorage, AK 99508-4661 | 2016-05-17 |
| 1255730438 | Dorothea Joyleeann Humann Zacharias | Advanced Practice Midwife | 3260 Providence Dr, Ste 322, Anchorage, AK 99508-4608 | 2014-08-14 |
| 1447679097 | Laina Cannon | Dietitian, Registered | 3260 Providence Dr, Ste 528, Anchorage, AK 99508-4661 | 2014-04-10 |
| 1568725877 | Sherifat Ajibike Ope Adenuga | Obstetrics & Gynecology | 3260 Providence Dr, Ste 322, Anchorage, AK 99508-4661 | 2012-06-21 |
| 1306121892 | Jillian Rae Schroeder | Social Worker | 3260 Providence Dr, C537, Anchorage, AK 99508-4661 | 2011-10-15 |
| 1073809547 | Tania H Hall | Obstetrics & Gynecology | 3260 Providence Dr, Ste 322, Anchorage, AK 99508-4661 | 2011-06-23 |
| 1861784407 | Amanda Lynn Beery | Obstetrics & Gynecology | 3260 Providence Dr, Ste 322, Anchorage, AK 99508-4661 | 2011-05-13 |
| 1700182706 | Paula Leslie Phillips | Counselor | 3260 Providence Dr, Suite 425, Anchorage, AK 99508-4661 | 2011-02-08 |
| 1437466935 | Kelly M Foster | Nurse Practitioner | 3260 Providence Dr, Ste. 523, Anchorage, AK 99508-4661 | 2010-09-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366063349 | Alexandra L Davis | Student in an Organized Health Care Education/Training Program | 1202 E 36th Ave, Anchorage, AK 99508 | 2020-05-01 |
| 1366087108 | The Salvation Army, A California Corporation | Community/Behavioral Health | 3600 East 20th Avenue, Anchorage, AK 99508 | 2019-11-15 |
| 1679120349 | Kila Gilcart | Speech-Language Pathologist | 161 Klevin Street #103, Anchorage, AK 99508 | 2019-08-19 |
| 1326692963 | Shannon Maillet | Behavior Technician | 1650 S Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1427602044 | Frank Harris Lawson Iv | Behavior Technician | 1650 S. Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1104470723 | Vivalesi Seforosa Nair | Behavior Technician | 1650 South Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1043864267 | The Cozy Chalet Assisted Living Home LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3707 Mt Blanc Circle, Anchorage, AK 99508 | 2019-07-25 |
| 1942861778 | Christine Mary Hoover | Registered Nurse | Alaska Native Medical Center - Inpatient Pediatrics, 4315 Diplomacy Dr, Anchorage, AK 99508 | 2019-06-24 |
| 1215594502 | Ashley Ongtowasruk | Case Manager/Care Coordinator | 4441 Dipomacy Dr, Suite 500, Anchorage, AK 99508 | 2019-05-22 |
| 1659937019 | Rayne Johnson | Behavior Technician | 4000 San Ernesto Blvd, Anchorage, AK 99508 | 2019-05-11 |
| Find all providers in zip 99508 | ||||
| Taxonomy Code | 207RE0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Endocrinology, Diabetes & Metabolism |
| An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962580480 | Jerry Ross Tanner II | Internal Medicine | 2841 Debarr Rd Ste 43, Anchorage, AK 99508-2967 | 2006-11-01 |
| 1184606014 | Janice Ann Koval | Internal Medicine | 2841 Debarr Rd Ste 50, Anchorage, AK 99508-2945 | 2005-11-16 |
| 1114441227 | Jeffrey D Medland, LLC | Internal Medicine | 3260 Providence Dr Ste 523, Anchorage, AK 99508-4608 | 2017-07-31 |
| 1659521888 | J. Ross Tanner, D.o. LLC | Internal Medicine | 2841 Debarr Rd, Suite 43, Anchorage, AK 99508-2932 | 2008-09-24 |
| 1306022314 | Konrad C Kaltenborn Md | Internal Medicine | 4100 Lake Otis Pkwy, Ste 305, Anchorage, AK 99508-5229 | 2008-01-21 |
| 1780733105 | Jeffrey Dale Medland | Internal Medicine | 2841 Debarr Rd, Suite 43, Anchorage, AK 99508-2958 | 2007-01-09 |
| 1821056284 | John J Regan Jr. | Internal Medicine | 2925 Debarr Rd, Anchorage, AK 99508-2983 | 2006-05-03 |
| 1710943196 | Jeanne R Bonar | Internal Medicine | 3260 Providence Dr, #523, Anchorage, AK 99508-4608 | 2006-04-25 |
| 1972589299 | Konrad C Kaltenborn | Internal Medicine | 3260 Providence Dr, #523, Anchorage, AK 99508-4608 | 2005-12-19 |
| 1043294648 | Internal Medicine Associates, LLC | Internal Medicine | 2841 Debarr Rd Ste 50, Anchorage, AK 99508-2945 | 2005-12-06 |
| Find all providers in ANCHORAGE | ||||
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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.