David N Ampong
Organization Active NPI Psychiatric/Mental Health Nurse Practitioner · Anchorage, AK
NPI 1104464460 · NPPES record last updated May 20, 2025
Key facts
- NPI
- 1104464460
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- Legal business name
- DAVID N AMPONG
- Practice address
- 1577 C St Ste 201
Anchorage, AK 99501-5164 - Phone
- (907) 538-9958
- Fax
- (907) 865-2433
- NPI assigned
- Dec 18, 2019
- Organization subpart
- No
Authorized official
- Name
- Jennifer McDermott
- Title
- Credentialing Specialist
- Phone
- (505) 712-2662
Practitioners 3
-
David Nana Ampong, DNP
-
Kevin Julius Barrett, ANP-BC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240528002220 | AK | Part B Supplier - Clinic/Group Practice | 2365884913 |
Receives reassigned benefits from 3 practitioners Practice locations: Anchorage, AK |
National Provider Directory
Locations
130 W International Rd
Anchorage, AK 99518
1577 C St
Ste 204
Anchorage, AK 99501
Phone (907) 205-6912
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X | |||
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X | Yes |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1701389 | Medicaid | AK |
Other names
- Alaska Treatment Center
Other providers in Anchorage, AK
- David C. Wrigley MD PC
- David D Beal MD PC
- David D Beal, MD
- David H. Brock, Inc
- David J Pedigo OD PS
- Stacey David-Reay
- Amalia David
- Brie David
- Claudette Irene David
- Lindsey David
All providers in Anchorage, AK · Psychiatric/Mental Health Nurse Practitioner in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.