NPIMap

Organization Active NPI

Tundra Health Initiative Corp

  • Optometrist
  • Nome, AK
National Provider Identifier
1063103224
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
TUNDRA HEALTH INITIATIVE CORP
Practice address
309 Bering St
#1049
Nome, AK 99762-1049
Phone
(907) 443-3553
Fax
(844) 901-4313
NPI assigned
May 18, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2023

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

Authorized official

Name
Marcy Oneil, ODNPI 1881905172
Title
President
Phone
(907) 443-3553

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

309 Bering St
#1049
Nome, AK 99762-1049

Mailing address

309 Bering St
#1049
Nome, AK 99762-1049
Phone (907) 443-3553

Other identifiers 2

IdentifierTypeStateIssuer
1023244MedicaidAK
1570705MedicaidAK

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1684368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684368000000",
    "number": "1063103224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 BERING ST",
            "address_2": "#1049",
            "city": "NOME",
            "state": "AK",
            "postal_code": "997621049",
            "telephone_number": "907-443-3553",
            "fax_number": "844-901-4313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 BERING ST",
            "address_2": "#1049",
            "city": "NOME",
            "state": "AK",
            "postal_code": "997621049",
            "telephone_number": "907-443-3553",
            "fax_number": "844-901-4313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TUNDRA HEALTH INITIATIVE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-18",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-05",
        "status": "A",
        "authorized_official_last_name": "ONEIL",
        "authorized_official_first_name": "MARCY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "907-443-3553",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023244",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1570705",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nome, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; 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.