Individual provider Active NPI

Loetta Mae Horswill-Woods, DO

  • Internal Medicine Physician
  • Wasilla, AK
National Provider Identifier
1164479374
Registry record updated Oct 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4740 Issued in AK
Practice address
3719 E Meridian Loop
Suite F
Wasilla, AK 99654-7270
Phone
(907) 373-5940
Fax
(907) 373-5947
NPI assigned
May 31, 2006
Last updated
Oct 18, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4740 AK Primary

Addresses

Primary practice location

3719 E Meridian Loop
Suite F
Wasilla, AK 99654-7270

Mailing address

3719 E Meridian Loop
Suite F
Wasilla, AK 99654-7270
Phone (907) 373-5940

Other identifiers 1

IdentifierTypeStateIssuer
MD5445MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040329000934 AK Practitioner - Internal Medicine 4486546991 Receives reassigned benefits from 1 practitioner
Practice locations: Wasilla, AK

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
4740AKMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wasilla Internal Medicine LLC Internal Medicine CurrentSince Sep 5, 2001 Accepting new patients
Mat-Su Valley Medical Center LLC Past Accepting new patients
Alaska Heart Institute Past Accepting new patients

Locations

3719 E Meridian Loop
Ste F
Wasilla, AK 99654
Phone (907) 313-7537

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17085/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

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.

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192665600000",
    "number": "1164479374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3719 E MERIDIAN LOOP",
            "address_2": "SUITE F",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547270",
            "telephone_number": "907-373-5940",
            "fax_number": "907-373-5947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3719 E MERIDIAN LOOP",
            "address_2": "SUITE F",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547270",
            "telephone_number": "907-373-5940",
            "fax_number": "907-373-5947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORSWILL-WOODS",
        "first_name": "LOETTA",
        "middle_name": "MAE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2007-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AK",
            "license": "4740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD5445",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

Verify at the official NPI Registry.