Mat-Su Community Pediatrics, P.C.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

MAT-SU COMMUNITY PEDIATRICS, P.C.

Practice address

3750 E. Country Field Circle
Suite C
Wasilla, AK 99654

Phone

(907) 357-2955

Fax

(907) 357-9348

NPI assigned

Nov 2, 2009

Last updated

Nov 2, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Tamara M Krimm, M.D., F.A.A.P.NPI 1164502829

Title

President/Chief Medical Officer

Phone

(907) 357-2955

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tamara M Krimm, MD FAAP

  • Pediatrics Physician
  • Kailua Kona, HI
  • NPI 1164502829
  NPD (past) Authorized official
• Desiree Dawn Cook, CPNP-PC, PMHNP

  • Pediatric Nurse Practitioner
  • Wasilla, AK
  • NPI 1831602341
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1257120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257120000000",
    "number": "1003142621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 E. COUNTRY FIELD CIRCLE",
            "address_2": "SUITE C",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "99654",
            "telephone_number": "907-357-2955",
            "fax_number": "907-357-9348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 E. COUNTRY FIELD CIRCLE",
            "address_2": "SUITE C",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "99654",
            "telephone_number": "907-357-2955",
            "fax_number": "907-357-9348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAT-SU COMMUNITY PEDIATRICS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-02",
        "last_updated": "2009-11-02",
        "status": "A",
        "authorized_official_last_name": "KRIMM",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT/CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "907-357-2955",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., F.A.A.P."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mat Su Youth Housing-My House (MY House)
• Mat-Su Activity and Respite Center
• Mat-Su Activity and Respite Center
• Mat-Su Birth Center, LLC
• Mat-Su Chiropractic LLC (Mat-Su Chiropractic)
• Mat-Su Dental Center, Inc.
• Mat-Su Integrative Medicine
• Mat-Su Medical Laboratory, LLC.
• Mat-Su Mental Health LLC
• Mat-Su Midwifery Inc

• Pediatrics Physician in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Pediatrics Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.