JASON BEAU DELUISA (NPI# 1629200894) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629200894 |
| Entity Type | Individual |
| Full Name | JASON BEAU DELUISA |
| Credential | ANP |
| Practice Address |
3801 Lake Otis Pkwy Ste 112 Anchorage AK 99508-5234 |
| Mailing Address |
25822 Berryhill Rd Eagle River AK 99577-9603 |
| Practice Telephone | 9072025577 |
| Practice Fax Number | 9078652433 |
| Mailing Telephone | 5053310295 |
| Mailing Fax Number | 9078652433 |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2019-09-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
117659 | AK | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
CNP-01518 | NM | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
117659 | AK | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 37805771 | 05 | |
| AK | 1666771 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3801 Lake Otis Pkwy Ste 112, Anchorage, AK 995085234 | 9072025577 | 9078652433 |
| 550 W 7th Ave, Suite A, Anchorage, AK 995013571 | 9072697397 |
| Street Address |
3801 LAKE OTIS PKWY STE 112 |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99508-5234 |
| 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 | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760017123 | Sara Rottman | Nurse Practitioner | 2210 Sentry Dr Apt 14, Anchorage, AK 99507-5353 | 2020-03-05 |
| 1104464460 | David Ampong | Nurse Practitioner | 1577 C St Ste 204, Anchorage, AK 99501-5164 | 2019-12-18 |
| 1154897429 | Kristerra Nicole Yawea | Nurse Practitioner | 2440 E Tudor Rd # 384, Anchorage, AK 99507-1185 | 2018-10-15 |
| 1982187399 | Sara A Lindsoe | Nurse Practitioner | 8136 White Dr, Anchorage, AK 99507-6046 | 2018-09-11 |
| 1609326594 | Virginia Walker | Nurse Practitioner | 3211 Providence Drive Rh Ste 116, University of Alaska Anchorage Student Health & Councel, Anchorage, AK 99508 | 2016-10-04 |
| 1649622457 | Jenifer Swigart | Nurse Practitioner | 915 W. Northern Lights Blvd, Anchorage, AK 99503 | 2016-07-05 |
| 1649591504 | Karen E Sasnett | Nurse Practitioner | 4321 Gannett Cir, Anchorage, AK 99504-4203 | 2010-06-15 |
| 1790001899 | Peter Fritz Alward | Nurse Practitioner | 1500 Debarr Cir, Anchorage, AK 99508-2984 | 2010-04-14 |
| 1407189764 | Holly Dimeglio, Anp | Nurse Practitioner | 1407 W. 31st Ave, Ste 201, Anchorage, AK 99503 | 2009-09-17 |
| 1134397334 | Leona Marie Gillespie | Nurse Practitioner | 701 E Tudor Rd Ste 135, Anchorage, AK 99503-7459 | 2008-02-11 |
| 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.