KEVIN C. BERG, O.D., LLC (NPI# 1881660207) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881660207 |
| Entity Type | Organization |
| Organization Name | KEVIN C. BERG, O.D., LLC |
| Practice Address |
1350 S Seward Meridian Pkwy Wasilla AK 99654-8332 |
| Practice Telephone | 9073760835 |
| Practice Fax Number | 9073760843 |
| Mailing Telephone | 9073760835 |
| Mailing Fax Number | 9073760843 |
| Enumeration Date | 2006-02-25 |
| Last Update Date | 2008-03-11 |
| Authorized Official Name | KEVIN CRAIG BERG (OWNER) |
| Authorized Official Telephone | 9073760835 |
| Authorized Official Credential | O.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 104 | AK | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | OD1144 | 05 |
| Street Address |
1350 S SEWARD MERIDIAN PKWY |
| City | WASILLA |
| State | AK |
| Zip Code | 99654-8332 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104432715 | Saniye Nur Zen Stevens | Pharmacist | 1350 S Seward Meridian Pkwy, Wasilla, AK 99654-8332 | 2020-09-18 |
| 1992197362 | Justin Elliot Profitt | Pharmacist | 1350 S Seward Meridian Pkwy, Wasilla, AK 99654-8332 | 2015-02-23 |
| 1639422967 | Mark Clafshenkel | Pharmacist | 1350 S Seward Meridian Pkwy, Wasilla, AK 99654-8332 | 2012-10-24 |
| 1659622736 | Mary Jane Allen | Pharmacist | 1350 S Seward Meridian Pkwy, Wasilla, AK 99654-8332 | 2012-09-28 |
| 1811248578 | Seth Dye | Pharmacist | 1350 S Seward Meridian Pkwy, Wasilla, AK 99654-8332 | 2012-09-20 |
| 1629247820 | Kevin Craig Berg | Optometrist | 1350 S Seward Meridian Pkwy, Wasilla, AK 99654-8332 | 2008-02-21 |
| 1336166644 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 1350 S Seward Meridian Pkwy, Wasilla, AK 99654-8332 | 2006-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003426784 | Colleen Maggie Newcity | Case Manager/Care Coordinator | 851 Westpoint Suite 310, Wasilla, AK 99654 | 2020-08-06 |
| 1659995884 | Amy M Lowe | Peer Specialist | 1363 W Spuce Ave, Wasilla, AK 99654 | 2020-06-03 |
| 1922648690 | Achieve Medical Alaska LLC | Clinic/Center | 1981 E Palmer, Suite 230, Wasilla, AK 99654 | 2020-01-10 |
| 1588205538 | Juan Carlos Garcia | Physician Assistant | 950 East Bogard Road, Suite 103, Wasilla, AK 99654 | 2019-10-01 |
| 1427610864 | Sharon Webb | Counselor | 705 S Knik Goose Bay Rd Suite K, Wasilla, AK 99654 | 2019-07-06 |
| 1306401864 | Logan Lee Cook | Peer Specialist | 2953 E Fairview Loop, Wasilla, AK 99654 | 2019-05-09 |
| 1053883595 | Moose Creek Medical Clinic LLC | Nurse Practitioner | 2341 S. Fern St., Suite 300, Wasilla, AK 99654 | 2018-12-21 |
| 1487124962 | Melissa A Stevens | Massage Therapist | 2201 W That Rd, Wasilla, AK 99654 | 2018-11-28 |
| 1609359561 | Audrey E Beers | Midwife | 2405 S. Knik Goose Bay Rd., Wasilla, AK 99654 | 2018-09-07 |
| 1093297418 | Karlee Janine Mccorry | Occupational Therapist | 613 S Knik-goose Bay Rd, Wasilla, AK 99654 | 2018-09-01 |
| Find all providers in zip 99654 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942832183 | Alexandra Jordan Louise Coon | Optometrist | 935 E Westpoint Dr Ste 207, Wasilla, AK 99654-7181 | 2020-02-05 |
| 1528503158 | Eye Guys LLC | Optometrist | 285 E Parks Hwy, Wasilla, AK 99654-7039 | 2017-01-06 |
| 1063740363 | Wolf Eye Center, Inc. | Optometrist | 4505 E Greenstreet Circle, Wasilla, AK 99654 | 2009-11-24 |
| 1164546313 | Michael Sukkyu Kim | Optometrist | 1000 Seward Meridian Highway, Wasilla, AK 99654 | 2007-03-16 |
| 1194854604 | Alaska Eye Care Centers, Apc | Optometrist | 1700 E Parks Hwy # 300, Wasilla, AK 99654-7352 | 2007-03-02 |
| 1376504035 | Marilyn Holm | Optometrist | 1320 S Countrywood Dr, Wasilla, AK 99623-9228 | 2006-03-31 |
| 1144295809 | Lynn J Coon | Optometrist | 935 E Westpoint Dr, Ste 207, Wasilla, AK 99654 | 2006-02-17 |
| 1730186867 | Edward Carl Godnig | Optometrist | 285 E Parks Hwy Ste A, Wasilla, AK 99654-7039 | 2005-07-05 |
| 1992344923 | Cap Eye LLC | Optometrist | 3122 E Meridian Park Loop, Wasilla, AK 99654-7255 | 2019-12-20 |
| 1063068328 | Austin Anderson | Optometrist | 4505 E Greenstreet Cir, Wasilla, AK 99654-8425 | 2019-08-13 |
| Find all providers in WASILLA | ||||
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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.