RAINBOW MEDICAL CLINIC (NPI# 1861637555) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861637555 |
| Entity Type | Organization |
| Organization Name | RAINBOW MEDICAL CLINIC |
| Other Organization Name | STEPHEN SHORTRIDGE |
| Practice Address |
10927 West Parks Hwy. Big Lake AK 99652-0562 |
| Mailing Address |
Po Box 520562 Big Lake AK 99652-0562 |
| Practice Telephone | 9078923350 |
| Practice Fax Number | 9078923351 |
| Mailing Telephone | 9078923350 |
| Mailing Fax Number | 9078923351 |
| Enumeration Date | 2008-12-09 |
| Last Update Date | 2009-07-23 |
| Authorized Official Name | MR. STEPHEN MATTHEW SHORTRIGE (OWNER) |
| Authorized Official Telephone | 9078923350 |
| Authorized Official Credential | PA-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 394 | AK | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NPI | 1700994118 | 01 |
| Other Name | Type Code |
|---|---|
| Stephen Shortridge | Other Name - Individual/Organization |
| Street Address |
10927 WEST PARKS HWY. |
| City | BIG LAKE |
| State | AK |
| Zip Code | 99652-0562 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790394914 | Heather Ruth Edgren | Technician | 13784 W Airigin Dr, Big Lake, AK 99652 | 2020-07-23 |
| 1740745439 | Susan Olson Dmd Inc | Clinic/Center | 3261 S. Big Lake Rd. Ste D3-d4, Big Lake, AK 99652 | 2019-02-06 |
| 1306293428 | Renae Jean Nelson | Massage Therapist | 3498 South Lakeview Loop, Big Lake, AK 99652 | 2016-05-18 |
| 1568828614 | Lakeview Massage Therapy | Massage Therapist | 3498 S Lakeview Loop, Big Lake, AK 99652 | 2016-01-05 |
| 1679995435 | Julie Dittman | Registered Nurse | 14988 W. Fireweed Dr., Big Lake, AK 99652 | 2014-01-14 |
| 1891034575 | Kidability Physical Therapy, LLC | Physical Therapist | 6406 S. Gonder Road, Big Lake, AK 99652 | 2013-01-31 |
| 1912250804 | Valley Mover | Bus | 8336 W Parks Highway, Meadow Lakes, AK 99652 | 2012-10-17 |
| 1013047117 | Arctic Chiropractic West Mat-su, LLC | Chiropractor | Mile 51 George Parks Hwy, #2, Big Lake, AK 99652 | 2007-03-07 |
| 1467824359 | Margaret Maixner | Nurse Practitioner | 7593 Larry's Lane, Big Lake, AK 99652-1792 | 2015-10-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962011635 | Chad Talbot | Counselor | 19591 Station St Apt 308, Big Lake, MN 55309-9436 | 2020-07-28 |
| 1366051203 | Chrystle Williefay White | Massage Therapist | 12900 W Creek Frontage Rd, Big Lake, AK 99623-4880 | 2020-07-27 |
| 1790394914 | Heather Ruth Edgren | Technician | 13784 W Airigin Dr, Big Lake, AK 99652 | 2020-07-23 |
| 1073121166 | Kira Jeannette Powell | Dentist | 20460 County Road 11 Nw, Big Lake, MN 55309-4851 | 2020-07-15 |
| 1295353621 | Moriah Gabrielle Krueger | Counselor | 19900 214th Ave Nw, Big Lake, MN 55309-8977 | 2020-07-13 |
| 1356986475 | Barbro E Strom Langley | Technician | 16901 River View Cir, Big Lake, MN 55309 | 2019-11-13 |
| 1457901506 | Centracare Health System | Emergency Medicine | 121 Lake St N, Big Lake, MN 55309-9254 | 2019-09-19 |
| 1740745439 | Susan Olson Dmd Inc | Clinic/Center | 3261 S. Big Lake Rd. Ste D3-d4, Big Lake, AK 99652 | 2019-02-06 |
| 1457821795 | Grant Michael Vickerman | Specialist/Technologist | 22037 181st St Nw, Big Lake, MN 55309-8243 | 2018-11-29 |
| 1053813956 | Donna Gotzian | Registered Nurse | 18874 243rd Ave Nw, Big Lake, MN 55309-8208 | 2018-03-06 |
| Find all providers in BIG LAKE | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336557297 | Angela Lee Mcgee | Physician Assistant | 207 Jefferson Blvd, Big Lake, MN 55309-4667 | 2014-07-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013517226 | Robin Lynn Morris | Physician Assistant | 3275 Togiak St, Kenai, AK 99611-8483 | 2020-10-27 |
| 1588205538 | Juan Carlos Garcia | Physician Assistant | 950 East Bogard Road, Suite 103, Wasilla, AK 99654 | 2019-10-01 |
| 1043775414 | Brandon James Wilson | Physician Assistant | Uscg Base Kodiak Rockmore-king Clinic, 200 Albatross Ave Bldg N-46, Kodiak, AK 99615-6810 | 2019-02-09 |
| 1679056659 | Bennett Robert Stadler | Physician Assistant | 673 Mdg 5955 Zeamer Avenue, Jber, AK 99506 | 2018-09-14 |
| 1427539261 | Aimee Johnson | Physician Assistant | 1640 Cowles St Ste 1, Fairbanks, AK 99701-5908 | 2018-08-28 |
| 1801376702 | Matthew Gerard Somma | Physician Assistant | 1-25 Attack Reconnaissance Bn, Fort Wainwright, AK 99703 | 2018-08-20 |
| 1215443122 | Denali Surgical Services, LLC | Physician Assistant | 12110 Business Blvd Ste 6 #410, Eagle River, AK 99577-7798 | 2017-12-15 |
| 1497274419 | Pearl Margaret Churchill | Physician Assistant | Usibelli Spur Road, Healy, AK 99743 | 2017-09-11 |
| 1912426040 | Ashley Boge | Physician Assistant | 2925 Debarr Rd Ste D350, Anchorage, AK 99508-2959 | 2017-09-09 |
| 1215455597 | Leigha Henry-waugh | Physician Assistant | 3724 Lincoln Ellsworth Ct Unit B, Anchorage, AK 99517-2354 | 2017-09-06 |
| Find all providers with the same taxonomy | ||||
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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.