MAT-SU EAR, NOSE, THROAT & FACIAL PLASTICS, INC. (NPI# 1912010687) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912010687 |
| Entity Type | Organization |
| Organization Name | MAT-SU EAR, NOSE, THROAT & FACIAL PLASTICS, INC. |
| Other Organization Name | FACIAL PLASTIC ENT & ASSOCIATES, INC |
| Practice Address |
2490 South Woodworth Loop 201 Palmer AK 99645 |
| Practice Telephone | 9077459200 |
| Practice Fax Number | 9077459201 |
| Mailing Telephone | 9077459200 |
| Mailing Fax Number | 9077459201 |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2017-12-27 |
| Authorized Official Name | ANDREW RICHARD PULLIAM (PRESIDENT) |
| Authorized Official Telephone | 9077459200 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 4516 | AK | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | MD3510 | 05 | |
| AK | 1020801 | 05 |
| Other Name | Type Code |
|---|---|
| Facial Plastic ENT & Associates, Inc | Former Legal Business Name - Organization |
| Street Address |
2490 SOUTH WOODWORTH LOOP 201 |
| City | PALMER |
| State | AK |
| Zip Code | 99645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366618530 | Curis Andrew Mina | Orthopaedic Surgery | 2490 South Woodworth Loop, Medical Plaza, Suite 350, Palmer, AK 99645 | 2008-05-07 |
| 1063552115 | Alaska Neurological Surgery LLC | Neurological Surgery | 2490 South Woodworth Loop, Suite 450, Palmer, AK 99645 | 2007-02-07 |
| 1396849428 | Mat-su Surgical Associates Apc | Surgery | 2490 South Woodworth Loop, Suite 400, Palmer, AK 99645 | 2006-09-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295357135 | Kasey M Flintoft | Occupational Therapist | 7200 E. Jim Cottrell Cir, Palmer, AK 99645 | 2020-05-14 |
| 1629601471 | Courtney Randol | Licensed Practical Nurse | 14405 E Pace Dr., Palmer, AK 99645 | 2020-02-20 |
| 1689213092 | Valerie Anne Delaune | Acupuncturist | 9693 N. Little Otter Dr., Palmer, AK 99645 | 2020-01-02 |
| 1003464512 | Alaskan Sunrise Behavioral Health, L.L.C. | Clinic/Center | 14460 E. Pace Dr., Palmer, AK 99645 | 2019-08-28 |
| 1548814718 | Maple Springs of Palmer Snf Holdings, LLC | Skilled Nursing Facility | 12130 E Maple Springs Way, Palmer, AK 99645 | 2019-07-26 |
| 1952868655 | Carla Beth Kelly | Physical Therapist | 7200 Jim Cottrell Circle, Palmer, AK 99645 | 2019-02-28 |
| 1366938375 | Wendy S Page | Behavior Technician | 7200 E Jim Cottrell, Wasilla, AK 99645 | 2018-07-03 |
| 1154845170 | Sarah Elizabeth Gilliland | Occupational Therapist | 7200 E Jim Cottrell Circle, Palmer, AK 99645 | 2017-08-01 |
| 1558885137 | Garland Brooks | Massage Therapist | 1934 Prospect Dr, Palmer, AK 99645 | 2017-07-26 |
| 1386165009 | Sommer Dawn Nielsen | Massage Therapist | 3566 N Mars Ave., Palmer, AK 99645 | 2017-07-03 |
| Find all providers in zip 99645 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619244100 | Ann Marie Lofgreen | Specialist | 432 S Alaska St, Palmer, AK 99645-6338 | 2011-11-28 |
| 1831191527 | Michael Glen Fitzgerald | Specialist | 2490 S Woodworth Lp, Suite 104, Palmer, AK 99645-7405 | 2005-08-11 |
| 1932432036 | Mary Jane Knox Neavill-patterson | Specialist | 1150 S Colony Way, # 10, Palmer, AK 99645-6900 | 2009-09-09 |
| 1932363223 | Rodelmiro Valdez | Specialist | 6921 E Garth Cir, Palmer, AK 99645-5922 | 2008-07-15 |
| 1568642320 | Melissa Lalli | Specialist | 1581 N Main St, Palmer, MA 01069-1232 | 2007-11-09 |
| 1295758670 | Hill & Llewellyn, LLC. | Specialist | 2490 S. Woodworth Loop, Suite 401, Palmer, AK 99645 | 2006-07-26 |
| 1699795526 | Natalie Beyeler, D.o. | Specialist | 6921 E Garth Cir Ste A, Palmer, AK 99645-5922 | 2006-07-21 |
| 1972522415 | Aurora Womens Health Care | Specialist | 2490 S Woodworth Lp, Suite 200, Palmer, AK 99645-7405 | 2006-07-18 |
| 1730130014 | Trevor Van Oostrom | Specialist | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2006-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144790742 | Danielle M Hall | Specialist | 2925 Debarr Rd Ste 399, Anchorage, AK 99508-2966 | 2018-11-27 |
| 1497235642 | Beth Alta Fletcher | Specialist | 737 W 5th Ave Ste 202, Anchorage, AK 99501 | 2018-08-17 |
| 1811406143 | Joshua Hawley | Specialist | 43335 Kalifornsky Beach Rd Ste 25, Soldotna, AK 99669-8280 | 2017-09-29 |
| 1235668443 | Aimee M Hull-malnoske | Specialist | 22211 Brownie Dr, Eagle River, AK 99577-9520 | 2017-06-09 |
| 1982145637 | The Oriental Healing Arts Center LLC | Specialist | 2636 Spenard Rd, Anchorage, AK 99503-2336 | 2017-03-14 |
| 1720522410 | Rebecca Carter | Specialist | 5013 Marlowe Ave, A, Anchorage, AK 99508-3738 | 2016-12-14 |
| 1942744875 | Samantha Lange | Specialist | 11421 Old Glenn Hwy Ste 101, Eagle River, AK 99577-7783 | 2016-12-12 |
| 1770035883 | Anne Honer | Specialist | 8641 Brookway Cir, Anchorage, AK 99504-4274 | 2016-10-25 |
| 1548711005 | Gordon Jay Wallis | Specialist | 142 W 5th Ave, Anchorage, AK 99501-2522 | 2016-10-19 |
| 1194272971 | William L Emery | Specialist | 3789 Blessing Ave, North Pole, AK 99705-6535 | 2016-09-08 |
| 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.