Active NPI
Merritt M Andruss, ANP
- Gerontology Nurse Practitioner
- Juneau, AK
National Provider Identifier
1114089232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- 566
- Practice address
- 4675 Glacier Hwy
Juneau, AK 99801-9518 - Phone
- (907) 321-5708
- Fax
- (907) 780-6425
- NPI assigned
- Dec 14, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 566 | AK | Primary |
Addresses
Primary practice location
4675 Glacier Hwy
Juneau, AK 99801-9518
Mailing address
20133 Cohen Dr
Juneau, AK 99801-8211
Phone (907) 957-1131
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NP2256 | Medicaid | AK |
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
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 566 | AK | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114089232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20133 COHEN DR",
"city": "JUNEAU",
"state": "AK",
"postal_code": "998018211",
"telephone_number": "907-957-1131",
"fax_number": "907-780-6425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4675 GLACIER HWY",
"city": "JUNEAU",
"state": "AK",
"postal_code": "998019518",
"telephone_number": "907-321-5708",
"fax_number": "907-780-6425"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDRUSS",
"first_name": "MERRITT",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "ANP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "AK",
"license": "566",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "NP2256",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Juneau, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.