Individual provider Active NPI

Michael Thomas Von Ah, WHNP

  • Women's Health Nurse Practitioner
  • Wasilla, AK
National Provider Identifier
1083640387
Registry record updated Jul 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
879 Issued in AK
Practice address
9761 W Margin Way
Wasilla, AK 99623
Phone
(907) 373-5400
Fax
(907) 373-5740
NPI assigned
Jun 25, 2006
Last updated
Jul 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 879 AK Primary

Addresses

Primary practice location

9761 W Margin Way
Wasilla, AK 99623

Mailing address

1125 N Colonial Dr
Wasilla, AK 99654-6760

Other identifiers 1

IdentifierTypeStateIssuer
NP0879MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
879AKMDPhysician Assistant

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531785600000",
    "number": "1083640387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 N COLONIAL DR",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996546760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9761 W MARGIN WAY",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "99623",
            "telephone_number": "907-373-5400",
            "fax_number": "907-373-5740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VON AH",
        "first_name": "MICHAEL",
        "middle_name": "THOMAS",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-25",
        "last_updated": "2018-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "AK",
            "license": "879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP0879",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2018; 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.