SWIFTWATER DERMATOLOGY LLC (NPI# 1760034045) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760034045 |
| Entity Type | Organization |
| Organization Name | SWIFTWATER DERMATOLOGY LLC |
| Practice Address |
209 W Katmai Ave Soldotna AK 99669-7409 |
| Practice Telephone | 9072272373 |
| Mailing Telephone | 9072272373 |
| Enumeration Date | 2019-07-16 |
| Last Update Date | 2019-07-16 |
| Authorized Official Name | KRISTIN L EASTMAN (OWNER/PROVIDER) |
| Authorized Official Telephone | 9072272373 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| SWIFTWATER DERMATOLOGY | Doing Business As Name - Organization |
| Street Address |
209 W KATMAI AVE |
| City | SOLDOTNA |
| State | AK |
| Zip Code | 99669-7409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881201226 | Kyle Arron Shassetz | Counselor | 43335 K-beach Rd., Soldotna, AK 99669 | 2020-09-29 |
| 1720614993 | Peninsula Instacare | Clinic/Center | 34581 Kenai Spur Hwy, Suite 1, Soldotna, AK 99669 | 2020-03-19 |
| 1871141077 | Alaine Viola Lagasse | Counselor | Kenai Vet Center, 43299 Kalifornsky Beach Road Ste 4, Soldotna, AK 99669 | 2019-08-30 |
| 1962970574 | Ryder R Storm | Behavior Technician | 338800 Community College Drive, Suite 1, Soldotna, AK 99669 | 2018-11-13 |
| 1356821540 | Tanecia Webster | Nurse Practitioner | 36570 Kenai Spur Hwy, Ste 103a, Soldotna, AK 99669 | 2018-08-16 |
| 1821519869 | Theresa Napolitano | Case Manager/Care Coordinator | 35477 Kenai Spur Hwy Suite 203, Soldotna, AK 99669 | 2017-06-29 |
| 1689048282 | Jeanne Bignell | Licensed Practical Nurse | 35020 Alaskan View Lane, Soldotna, AK 99669 | 2015-11-19 |
| 1952786105 | Ian Charles Mcmullen | Pharmacist | 44001 Sterling Highway, Soldotna, AK 99669 | 2015-07-29 |
| 1841679933 | Lana Clymer | Case Manager/Care Coordinator | 22994 Kalifornsky Beach Rd, Soldotna, AK 99669 | 2015-05-22 |
| 1861800773 | Phillip Bruce | Physical Therapy Assistant | 35105 Kenai Spury Hwy, Suite A, Soldotna, AK 99669 | 2014-07-24 |
| Find all providers in zip 99669 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245368695 | Mathew M Cannava | Dermatology | 247 N Fireweed St, Ste B, Soldotna, AK 99669-7540 | 2007-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932493327 | John Schultz | Dermatology | 8501 Sultana Dr, Anchorage, AK 99516-2561 | 2011-06-03 |
| 1669669867 | Layne Bedford Green | Dermatology | 5955 Zeamer Ave Ste 1, Elmendorf Afb, AK 99506-3702 | 2007-10-02 |
| 1295881977 | Gina M Brown | Dermatology | 3340 Providence Dr Ste A358, Anchorage, AK 99508-4691 | 2007-01-26 |
| 1649212937 | Michael L Cusack | Dermatology | 110 W 38th Ave Ste A2, Anchorage, AK 99503-5677 | 2006-06-12 |
| 1154363752 | Aesthetica Medical Spa LLC | Dermatology | 110 W 38th Ave, Ste A2, Anchorage, AK 99503-5650 | 2006-06-11 |
| 1346211505 | Kimberly Janne Wonderlich | Dermatology | 2775 College Road, Fairbanks, AK 99709 | 2006-01-27 |
| 1114998473 | Jayne S Fortson, Md | Dermatology | 2401 E 42nd Ave, Ste 301, Anchorage, AK 99508-5205 | 2006-01-26 |
| 1467448662 | Michael D Michener | Dermatology | 3841 Piper St Ste T4-020, Anchorage, AK 99508-4673 | 2005-09-22 |
| 1821093550 | Valley Dermatology Center, Inc. | Dermatology | 851 Westpoint Dr, Ste B10, Wasilla, AK 99654-7191 | 2005-06-17 |
| 1609420215 | Anchorage Dermatology & Cosmetics, LLC | Dermatology | 615 E 82nd Ave Ste 204, Anchorage, AK 99518-3159 | 2019-07-31 |
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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.