RAVEN'S SONG REHABILITATION, LLC (NPI# 1952717092) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952717092 |
| Entity Type | Organization |
| Organization Name | RAVEN'S SONG REHABILITATION, LLC |
| Practice Address |
6811 W Scatters Way Wasilla AK 99623-0878 |
| Practice Telephone | 9073157949 |
| Practice Fax Number | 8772207510 |
| Mailing Telephone | 9073157949 |
| Mailing Fax Number | 8772207510 |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2014-07-09 |
| Authorized Official Name | DIANA DAWN FERGUSON-WHEELER (OWNER) |
| Authorized Official Telephone | 9073157949 |
| Authorized Official Credential | PT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
1004364 | AK | Ambulatory Health Care Facilities |
| Street Address |
6811 W SCATTERS WAY |
| City | WASILLA |
| State | AK |
| Zip Code | 99623-0878 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679104723 | Lisa Newell | Home Health Aide | 7945 S. Settlers Bay Dr, Wasilla, AK 99623 | 2020-01-28 |
| 1780238014 | Bradley Duke Ischinger | Physical Therapy Assistant | 6701 Blondell Drive, Wasilla, AK 99623 | 2019-07-25 |
| 1508423625 | Ramon Ortiz | Counselor | 3940 N. El Taino Circle, Wasilla, AK 99623 | 2019-05-23 |
| 1689239782 | Kristine Ione Bayne | Counselor | 2651 N. Thordore Dr, Wasilla, AK 99623 | 2019-05-03 |
| 1801450382 | Desiree Feringa | Case Manager/Care Coordinator | 6640 S Calista Drive, Wasilla, AK 99623 | 2019-04-30 |
| 1861966269 | Tina Renee Hopkins | Assisted Living Facility | 3471 W Wren St, Wasilla, AK 99623 | 2019-01-18 |
| 1801382981 | Jaimie M Church | Social Worker | 6100 W Robin Hood Lane, Wasilla, AK 99623 | 2018-07-02 |
| 1861935975 | Mat-su Valley IIi LLC | Clinic/Center | 5851 South Knik-goose Bay Road, Wasilla, AK 99623 | 2016-11-21 |
| 1972980639 | Jesika Harrell | Physician Assistant | 500 East Benson Blvd, Suite 103, Anchorage, AK 99623 | 2015-05-01 |
| 1497175418 | Mark Hull | Contractor | 1465 N Meadow Lakes Loop, Wasilla, AK 99623 | 2014-04-17 |
| Find all providers in zip 99623 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588116909 | Medical Group of Alaska | Clinic/Center | 3190 E Meridian Park Loop, 206a, Wasilla, AK 99654-7422 | 2016-11-02 |
| 1730131467 | Excel Physical Therapy Limited Partnership | Clinic/Center | 1700 E Bogard Rd, Bldg B #203, Wasilla, AK 99654-6563 | 2006-05-17 |
| 1033758891 | Wu's Wellness LLC | Clinic/Center | 1700 E Bogard Rd Ste A203, Wasilla, AK 99654-6569 | 2019-12-27 |
| 1891208351 | Medical Group of Alaska, LLC | Clinic/Center | 3190 E Meridian Park Loop Ste 206a, Wasilla, AK 99654-7422 | 2017-11-07 |
| 1316478761 | Health Quest Therapy | Clinic/Center | 650 N Shoreline Dr, Wasilla, AK 99654-6677 | 2017-03-27 |
| 1821445636 | Rise Diagnostics, LLC | Clinic/Center | 3066 E Meridian Park Loop Ste 101, Wasilla, AK 99654 | 2016-05-22 |
| 1467796359 | Northern Edge Physical Therapy LLC | Clinic/Center | 984 N Meridian Pl Ste A, Wasilla, AK 99654-7215 | 2012-11-16 |
| 1205850674 | First Choice Physical Therapy, Inc. | Clinic/Center | 6701 W. Blondell St., Wasilla, AK 99654 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457979551 | Cooper Rehabilitation and Wellness, LLC | Clinic/Center | 115 Wooded Glen Ct, Kenai, AK 99611-6867 | 2020-07-06 |
| 1386268449 | Kesugi LLC | Clinic/Center | 36451 Birch Rd, Soldotna, AK 99669-9966 | 2020-06-04 |
| 1821617747 | Aurora Physical Therapy, LLC | Clinic/Center | 12601 Bona Kim Loop, Anchorage, AK 99515-4328 | 2020-04-10 |
| 1366083941 | Select Physical Therapy Holdings, Inc. | Clinic/Center | 220 Main Street Loop Unit A, Kenai, AK 99611-7724 | 2019-10-04 |
| 1871145995 | Recovery Waters Physical Therapy LLC | Clinic/Center | 9131 E Frontage Rd Ste 1, Palmer, AK 99645-9318 | 2019-07-09 |
| 1700445061 | Community Physical Therapy, Inc. | Clinic/Center | 4101 Arctic Blvd Ste 102, Anchorage, AK 99503-5702 | 2019-06-11 |
| 1497131049 | Vertical Physical Therapy LLC | Clinic/Center | 9109 Mendenhall Mall Rd Ste 5k, Juneau, AK 99801-7136 | 2015-08-05 |
| 1477936334 | Arctic Therapy and Rehab Bethel | Clinic/Center | 108 B Blackberry, Bethel, AK 99559-3466 | 2015-07-09 |
| 1154715928 | Relax Your Mind, Body and Soul | Clinic/Center | 559 Golden Morn St, Fairbanks, AK 99712 | 2015-03-19 |
| 1720416886 | Bodyiq Physical Therapy and Yoga | Clinic/Center | 322 Bartlett Blvd, Haines, AK 99827 | 2013-10-28 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on RAVEN'S SONG REHABILITATION, LLC.
| 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.