Active NPI
David N Ampong
Doing business as Alaska Treatment Center
- Psychiatric/Mental Health Nurse Practitioner
- Anchorage, AK
National Provider Identifier
1104464460
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- Legal business name
- DAVID N AMPONG
- Doing business as
- Alaska Treatment Center
- Practice address
- 1577 C St Ste 201
Anchorage, AK 99501-5164 - Phone
- (907) 538-9958
- Fax
- (907) 865-2433
- NPI assigned
- Dec 18, 2019
- Last updated
- May 20, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jennifer McDermott
- Title
- Credentialing Specialist
- Phone
- (505) 712-2662
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X | |||
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | Primary |
Addresses
Primary practice location
1577 C St Ste 201
Anchorage, AK 99501-5164
Mailing address
1577 C St Ste 201
Anchorage, AK 99501-5164
Phone (907) 538-9958
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1701389 | Medicaid | AK |
Other names 1
- Alaska Treatment Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AK
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
130 W International Rd
Anchorage, AK 99518
1577 C St
Ste 204
Anchorage, AK 99501
Phone (907) 205-6912
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Psychiatric/Mental Health Nurse Practitioner
- Anchorage, AK
- NPI 1174867428
-
- Psychiatric/Mental Health Nurse Practitioner
- Anchorage, AK
- NPI 1821743915
Multi-Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576627200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1747699200000",
"number": "1104464460",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1577 C ST STE 201",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995015164",
"telephone_number": "907-538-9958",
"fax_number": "907-865-2433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1577 C ST STE 201",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995015164",
"telephone_number": "907-538-9958",
"fax_number": "907-865-2433"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DAVID N AMPONG",
"organizational_subpart": "NO",
"enumeration_date": "2019-12-18",
"last_updated": "2025-05-20",
"certification_date": "2025-05-20",
"status": "A",
"authorized_official_last_name": "MCDERMOTT",
"authorized_official_first_name": "JENNIFER",
"authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
"authorized_official_telephone_number": "505-712-2662"
},
"taxonomies": [
{
"code": "261QR0405X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1701389",
"state": "AK"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Alaska Treatment Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Alaska Treatment Center",
"code": "3",
"type": "Doing Business As"
}
]
}
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 May 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.