FULL SPECTRUM PEDIATRICS, PC (NPI# 1639463953) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639463953 |
| Entity Type | Organization |
| Organization Name | FULL SPECTRUM PEDIATRICS, PC |
| Practice Address |
2841 Debarr Rd Bldg A, Suite 23 Anchorage AK 99508-2958 |
| Practice Telephone | 9076771864 |
| Practice Fax Number | 9078685167 |
| Mailing Telephone | 9076771864 |
| Mailing Fax Number | 9078685167 |
| Enumeration Date | 2011-06-03 |
| Last Update Date | 2011-06-03 |
| Authorized Official Name | DR. STEPHEN SCOTT BAKER (PRESIDENT) |
| Authorized Official Telephone | 9076771864 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 4587 | AK | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | 3255 | 05 |
| Street Address |
2841 DEBARR RD BLDG A, SUITE 23 |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99508-2958 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396748844 | Susan Canafax | Nurse Practitioner | 2841 Debarr Rd, Ste 25, Anchorage, AK 99508-2967 | 2005-05-28 |
| 1588113203 | Rebecca Libal | Nurse Practitioner | 2841 Debarr Rd, Suite 100, Anchorage, AK 99508-2958 | 2016-09-22 |
| 1619370319 | Alaska Regional Medical Group, LLC | Family Medicine | 2841 Debarr Rd, Anchorage, AK 99508-2958 | 2014-10-08 |
| 1497021588 | Radiology Services of Alaska Inc. | Radiology | 2841 Debarr Rd, Suite 12, Anchorage, AK 99508-2958 | 2012-03-22 |
| 1770857765 | Susan Canafax, Fnp | Nurse Practitioner | 2841 Debarr Rd, Suite 25, Anchorage, AK 99508 | 2012-03-08 |
| 1578864575 | Joshua D Hedberg | Physician Assistant | 2841 Debarr Rd, Suite #22, Anchorage, AK 99508-2958 | 2010-11-06 |
| 1437462363 | Mary Ann Jacob, M.d., LLC | Pediatrics | 2841 Debarr Rd, Suite 45, Anchorage, AK 99508-2958 | 2010-07-20 |
| 1831344050 | Donald W. Dippe Md A Professional Corporation | Ophthalmology | 2841 Debarr Rd, Suite 35, Anchorage, AK 99508-2967 | 2008-12-02 |
| 1659521888 | J. Ross Tanner, D.o. LLC | Internal Medicine | 2841 Debarr Rd, Suite 43, Anchorage, AK 99508-2932 | 2008-09-24 |
| 1487847851 | Grant Searles | Surgery | 2841 Debarr Rd, Suite 46, Anchorage, AK 99508-2932 | 2007-08-20 |
| 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 | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811596026 | Pivotal Care Partnership | Clinic/Center | 2925 Debarr Rd Ste 199, Anchorage, AK 99508-2959 | 2020-10-19 |
| 1255857876 | Vera Whole Health | Clinic/Center | 582 E 36th Ave Ste 203, Anchorage, AK 99503-4138 | 2017-08-15 |
| 1871020123 | Coburn Health Consulting LLC | Clinic/Center | 4401 Business Park Blvd # N-26, Anchorage, AK 99503-7172 | 2017-05-17 |
| 1558749903 | Atp Medicine, Ltd | Clinic/Center | 2000 W. International Rd, Building B Suite B4, Anchorage, AK 99502-9992 | 2015-05-18 |
| 1548657331 | Healing Journeys | Clinic/Center | 1401 W 34th Ave Ste 106, Anchorage, AK 99503-3655 | 2015-04-20 |
| 1356789366 | Urgent Care Medical Clinic, PC | Clinic/Center | 5437 E Northern Lights Blvd, Anchorage, AK 99508-4712 | 2013-06-12 |
| 1447523774 | Robert L. Lerner D.d.s | Clinic/Center | 9500 Independence Dr Ste 200, Anchorage, AK 99507-4617 | 2012-02-16 |
| 1194997429 | Denali Family Healthcare, LLC | Clinic/Center | 2841 Debarr Rd Ste 22, Anchorage, AK 99508-2945 | 2008-03-26 |
| 1497781678 | Urgent Care Medical Clinic, PC | Clinic/Center | 9150 Jewel Lake Rd, Suite B, Anchorage, AK 99502-5381 | 2006-06-23 |
| 1669936951 | Trua Health & Wellness | Clinic/Center | 7999 Jewel Lake Rd, Anchorage, AK 99502-4251 | 2019-01-30 |
| 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.