Ravencrest Medical LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

RAVENCREST MEDICAL LLC

Practice address

35670 Kenai Spur Hwy Ste 102
Soldotna, AK 99669-7649

Phone

(907) 921-2221

NPI assigned

May 23, 2024

Organization subpart

No

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

Authorized official

Name

Mrs. Danna Mavis Constance Moisii, PA-CNPI 1003318585

Title

Owner/Physician Assistant

Phone

(907) 921-2221

Specialties & licenses 1

Addresses

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IDCEDD

Practitioners 1

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

• Danna Mavis Constance Moisii, PA-C

  • Medical Physician Assistant
  • Soldotna, AK
  • NPI 1003318585
  NPD Authorized official

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

{
    "created_epoch": "1716422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716422400000",
    "number": "1033958491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35670 KENAI SPUR HWY STE 102",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697649",
            "telephone_number": "907-921-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35670 KENAI SPUR HWY STE 102",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697649",
            "telephone_number": "907-921-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAVENCREST MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-23",
        "last_updated": "2024-05-23",
        "certification_date": "2023-03-27",
        "status": "A",
        "authorized_official_last_name": "MOISII",
        "authorized_official_first_name": "DANNA",
        "authorized_official_middle_name": "MAVIS CONSTANCE",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "907-921-2221",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shane Russell Rall, MD
• Barbara Ransom, A.N.P.
• Heather Kulshan Rasch, CMT
• Erline M Rasmusan
• Sterling Rasmussen, LMT
• Ravencrest Medical LLC
• Jared Jordan Rawlings, PHARMD
• Readycare
• Annette Redington
• Susan A. Reed, PA-C

• Family Medicine Physician in Soldotna, AK
• Providers in Soldotna, AK by specialty
• Family Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; 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.