NPIMap

Organization Active NPI

Denali Cardiac and Thoracic Surgical Group LLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Anchorage, AK
National Provider Identifier
1033135447
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
Legal business name
DENALI CARDIAC AND THORACIC SURGICAL GROUP LLC
Practice address
2751 Debarr Rd Ste B320
Anchorage, AK 99508-6805
Phone
(907) 375-2000
Fax
(907) 375-5558
NPI assigned
Jul 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Authorized official

Name
Kenton Edgar Stephens Jr., MD
Title
Physician / Owner
Phone
(907) 375-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208G00000X Primary

Addresses

Primary practice location

2751 Debarr Rd Ste B320
Anchorage, AK 99508-6805

Mailing address

PO Box 3482
Post Falls, ID 83877-3482
Phone (208) 209-6170

Other identifiers 1

IdentifierTypeStateIssuer
K152964OtherAKMEDICARE ID

National Provider Directory

National Provider Directory

Locations

3841 Piper St
Ste 277
Anchorage, AK 99508
Phone (907) 375-2000

3841 Piper St
Ste T3-277
Anchorage, AK 99508
Phone (907) 375-2000

3300 Providence Dr
Ste 314
Anchorage, AK 99508
Phone (907) 561-9540

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601251200000",
    "number": "1033135447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3482",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838773482",
            "telephone_number": "208-209-6170",
            "fax_number": "208-209-6169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2751 DEBARR RD STE B320",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995086805",
            "telephone_number": "907-375-2000",
            "fax_number": "907-375-5558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENALI CARDIAC AND THORACIC SURGICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "KENTON",
        "authorized_official_middle_name": "EDGAR",
        "authorized_official_title_or_position": "PHYSICIAN / OWNER",
        "authorized_official_telephone_number": "907-375-2000",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "K152964",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; 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.