Family Medical Center

Key facts

NPI

1114026069

Entity type

Organization (NPI type 2)

Primary specialty

Non-Pharmacy Dispensing Site 332900000X

License

AA2011 (AK)

Legal business name

FAMILY MEDICAL CENTER

Practice address

2360 Service St
Delta Junction, AK 99737

Phone

(907) 895-5100

Fax

(907) 895-5133

NPI assigned

Sep 21, 2006

Organization subpart

No

Authorized official

Name

Ray Anderson

Title

Physician Owner

Phone

(907) 895-5100

Practitioners 1

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

• Raymond Edgar Andreassen, D.O. Family Medicine Physician · Delta Junction, AK · NPI 1972597185
  NPD (past)

National Provider Directory

Specialties & licenses

Addresses

Other identifiers

Other names

• RAY ANDREASSEN DO Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 12, 2008.

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218499200000",
    "number": "1114026069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 60 BOX 4860",
            "city": "DELTA JUNCTION",
            "state": "AK",
            "postal_code": "997379440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2360 SERVICE ST",
            "city": "DELTA JUNCTION",
            "state": "AK",
            "postal_code": "99737",
            "telephone_number": "907-895-5100",
            "fax_number": "907-895-5133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2008-08-12",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "RAY",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "907-895-5100"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "AK",
            "license": "AA2011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9969",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0227745",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RAY ANDREASSEN DO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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All providers in Delta Junction, AK · Non-Pharmacy Dispensing Site in Alaska