Angeles M Tavira-Dean, DIRECTOR, OWNER

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

436017 Issued in AK

Practice address

1301 Wintergreen St
Anchorage, AK 99508-3069

Phone

(907) 770-6315

Fax

(907) 770-1241

NPI assigned

Apr 3, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Eben-Ezer Home Care, LLC

  • Home Health Agency
  • Anchorage, AK
  • NPI 1437188158
  NPD (past)

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1174644355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 WINTERGREEN ST",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995083069",
            "telephone_number": "907-770-6315",
            "fax_number": "907-770-1241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 WINTERGREEN ST",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995083069",
            "telephone_number": "907-770-6315",
            "fax_number": "907-770-1241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVIRA-DEAN",
        "first_name": "ANGELES",
        "middle_name": "M",
        "credential": "DIRECTOR, OWNER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "AK",
            "license": "436017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PCG224",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katalina Tauta
• Jane Tautalafua
• Eteva Tautu, LPN
• Kory Taveras
• Vanna Elaine Sumabat Taveras, RN
• Lefia Tavita
• Greycy Tayan
• Teddy Tayan
• Sarah Jessica Taygan, CNM
• Kristin Taylor-Bond, BA, CDCI

• Home Health Agency in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Home Health Agency in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.