Realyn Sutter

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

101589 Issued in AK

Practice address

16502 Baird Cir
Eagle River, AK 99577-6710

Phone

(907) 696-0800

NPI assigned

Mar 18, 2024

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

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.

• Jades Care Alh

  • Assisted Living Facility
  • Eagle River, AK
  • NPI 1174486195
  NPD Authorized official
• Autumn Morningstar Assisted Living, LLC

  • Assisted Living Facility
  • Eagle River, AK
  • NPI 1649941881
  NPD

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1184483604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16502 BAIRD CIR",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995776710",
            "telephone_number": "907-696-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16502 BAIRD CIR",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995776710",
            "telephone_number": "907-696-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTER",
        "first_name": "REALYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-18",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AK",
            "license": "101589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Eagle River, AK
• Providers in Eagle River, AK by specialty
• Assisted Living Facility in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; 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.