Clinton Deaver, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

229469 Issued in AK

Practice address

7010 E Bogard Rd
Wasilla, AK 99654-4711

Phone

(907) 373-4732

NPI assigned

Sep 28, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Group practices

Atlas Medical Alaska LLCGroup PAC ID 0345630463, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ancora Home Health & Hospice Home health agency, Wasilla, AK, CCN 027008

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IIDDDD/Endpoint/IIDDDD
• Direct secure messaging: clinton.deaver@371240344420356.direct.elationemr.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Atlas Medical Alaska LLC

  • Internal Medicine Physician
  • Wasilla, AK
  • NPI 1376213207
  Medicare reassignment Care Compare group NPD
• Set Free Alaska, Inc.

  • Substance Abuse Rehabilitation Facility
  • Wasilla, AK
  • NPI 1073841789
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ancora Home Health & Hospice, LLC

  • Home Health Agency
  • Wasilla, AK
  • NPI 1801380043
  Care Compare affiliation

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

{
    "created_epoch": "1727481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1033937115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 876741",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996876741",
            "telephone_number": "907-373-4732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7010 E BOGARD RD",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996544711",
            "telephone_number": "907-373-4732"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5822 W Tidewater Dr",
            "address_purpose": "LOCATION",
            "city": "Wasilla",
            "state": "AK",
            "postal_code": "996230227",
            "country_code": "US",
            "telephone_number": "907-203-0072",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEAVER",
        "first_name": "CLINTON",
        "name_prefix": "Mr.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-28",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "229469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angelina De Ru
• Alissa Deal
• Lindsay Marie Deal
• Jeremiah E Dean
• Jody Dean, BS, CDC I
• Jessica Lyn Deay, PHARM.D.
• Forrest Debauw
• Lynne C Debolt, OTR/L
• Eugena A Decker
• Michael Francesco Decker

• Family Nurse Practitioner in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Family Nurse Practitioner in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.