NPIMap

Organization Active NPI

Alaska Pediatric Night Clinic, Inc.

  • Pediatrics Physician
  • Eagle River, AK
National Provider Identifier
1124558044
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
113174 Issued in AK
Legal business name
ALASKA PEDIATRIC NIGHT CLINIC, INC.
Practice address
20209 Eagle River Rd
Eagle River, AK 99577-6800
Phone
(907) 201-7801
NPI assigned
Jun 13, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Jennifer Austin, CPNP
Title
Ceo
Phone
(907) 201-7801

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 113174 AK Primary

Addresses

Primary practice location

20209 Eagle River Rd
Eagle River, AK 99577-6800

Mailing address

20209 Eagle River Rd
Eagle River, AK 99577-6800
Phone (907) 201-7801

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1497312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1124558044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20209 EAGLE RIVER RD",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995776800",
            "telephone_number": "907-201-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20209 EAGLE RIVER RD",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995776800",
            "telephone_number": "907-201-7801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALASKA PEDIATRIC NIGHT CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "907-201-7801",
        "authorized_official_credential": "CPNP"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "AK",
            "license": "113174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle River, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.