MAT SU VALLEY MEDICAL CENTER LLC (NPI# 1912950148) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912950148 |
| Entity Type | Organization |
| Organization Name | MAT SU VALLEY MEDICAL CENTER LLC |
| Other Organization Name | MAT-SU REGIONAL URGENT CARE |
| Practice Address |
950 Bogard Rd Wasilla AK 99654-7105 |
| Mailing Address |
Po Box 60000 Lockbox 74470 San Francisco CA 94160-0001 |
| Practice Telephone | 9078616000 |
| Practice Fax Number | 9078616559 |
| Mailing Telephone | 9078616000 |
| Mailing Fax Number | 9078616559 |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2008-03-04 |
| Authorized Official Name | LAURIE HOLTSFORD (DIRECTOR, BUSINESS OFFICE SUPPORT) |
| Authorized Official Telephone | 6154657466 |
| Is Organization Subpart | Y |
| Parent Organization Name | MAT SU VALLEY MEDICAL CENTER LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 261Q00000X | Clinic/Center | 299454 | AK | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | MDG1151 | 05 |
| Other Name | Type Code |
|---|---|
| Mat-Su Regional Urgent Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932282472 | Mat Su Valley Medical Center LLC | Durable Medical Equipment & Medical Supplies | 950 Bogard Rd, Wasilla, AK 99654-7105 | 2006-10-20 |
| 1003838384 | Mat Su Valley Medical Center LLC | Medicare Defined Swing Bed Unit | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2006-07-24 |
| 1669425898 | Mat Su Valley Medical Center LLC | Hospice Care, Community Based | 3051 Palmer Wasilla Hwy, Wasilla, AK 99654-7234 | 2006-05-18 |
| Street Address |
950 BOGARD RD |
| City | WASILLA |
| State | AK |
| Zip Code | 99654-7105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699734673 | Richard J Zajac | Internal Medicine | 950 Bogard Rd, 207, Wasilla, AK 99654-7105 | 2006-03-20 |
| 1194928234 | John R Oliver Md PC | Obstetrics & Gynecology | 950 Bogard Rd, Wasilla, AK 99654-7105 | 2007-06-07 |
| 1720105901 | Scott W Peterson | Physician Assistant | 950 Bogard Rd, Suite 233, Wasilla, AK 99654-7105 | 2007-03-23 |
| 1932282472 | Mat Su Valley Medical Center LLC | Durable Medical Equipment & Medical Supplies | 950 Bogard Rd, Wasilla, AK 99654-7105 | 2006-10-20 |
| 1669552550 | John Wayne Moore | Physician Assistant | 950 Bogard Rd, Suite 233, Wasilla, AK 99654-7105 | 2006-10-16 |
| 1134133499 | Alaska Heart Clinic, Inc | Internal Medicine | 950 Bogard Rd, Suite 207, Wasilla, AK 99654-7105 | 2006-07-29 |
| 1760413439 | John C Boston Do PC | Internal Medicine | 950 Bogard Rd, Suite 228, Wasilla, AK 99654-7105 | 2006-07-05 |
| 1881621860 | Melissa Peters, D.o. PC | Internal Medicine | 950 Bogard Rd, Suite 226, Wasilla, AK 99654-7105 | 2006-06-27 |
| 1093778029 | John Oliver | Obstetrics & Gynecology | 950 Bogard Rd, Suite 238, Wasilla, AK 99654-7105 | 2006-04-10 |
| 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 | 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 |
|---|---|---|---|---|
| 1942807862 | Turning Leaf Literacy Center, LLC | Clinic/Center | 690 E Susitna Ave, Wasilla, AK 99654-8124 | 2020-10-04 |
| 1982237921 | Revive Aesthetics & Spa Wasilla, LLC | Clinic/Center | 1175 N Leatherleaf Loop Ste F, Wasilla, AK 99654-6527 | 2020-02-18 |
| 1831399203 | Bald Mountain View Assisted Living Home | Clinic/Center | 1160 N Stanley Road, Wasilla, AK 99654-7018 | 2007-07-23 |
| 1407195522 | Frontier Family Medicine | Clinic/Center | 545 N Knik St, Wasilla, AK 99654-7022 | 2013-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811596026 | Pivotal Care Partnership | Clinic/Center | 2925 Debarr Rd Ste 199, Anchorage, AK 99508-2959 | 2020-10-19 |
| 1821560160 | Ideal Option, Pllc | Clinic/Center | 3159 Tongass Ave, Ketchikan, AK 99901-5745 | 2018-12-27 |
| 1902389943 | Ideal Option, Pllc | Clinic/Center | 8585 Old Dairy Rd Ste 200, Juneau, AK 99801-8094 | 2018-09-14 |
| 1063911287 | Ideal Option, Pllc | Clinic/Center | 416 Frontage Rd # 400, Kenai, AK 99611-7770 | 2018-02-02 |
| 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 |
| 1063958452 | Southeast Alaska Regional Health Consortium | Clinic/Center | Cannery Site, Excursion Inlet, AK 99850 | 2017-01-10 |
| 1962948356 | Southeast Alaska Regional Health Consortium | Clinic/Center | Community Building, Port Protection, AK 99950 | 2017-01-10 |
| 1659817054 | Southeast Alaska Regional Health Consortium | Clinic/Center | Naukati Community Church, Naukati, AK 99950 | 2017-01-10 |
| 1932645512 | Southeast Alaska Regional Health Consortium | Clinic/Center | 105 Nw Kodiak Dr, Coffman Cove, AK 99918 | 2017-01-06 |
| 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.