Individual provider Active NPI

Annie Dunnack, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Anchorage, AK
National Provider Identifier
1194071241
Registry record updated Feb 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
443 Issued in AK
Practice address
4050 Lake Otis Pkwy
Suite 201
Anchorage, AK 99508-5223
Phone
(860) 617-7719
NPI assigned
Jul 26, 2012
Last updated
Feb 10, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 443 AK Primary

Addresses

Primary practice location

4050 Lake Otis Pkwy
Suite 201
Anchorage, AK 99508-5223

Mailing address

5731 Radcliff Dr
Unit 1
Anchorage, AK 99504-3019
Phone (860) 617-7719

Other identifiers 1

IdentifierTypeStateIssuer
SP0049MedicaidAK

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
Master of Science

State licenses

LicenseStateTypeSpecialty
443AKMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1343260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391990400000",
    "number": "1194071241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5731 RADCLIFF DR",
            "address_2": "UNIT 1",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995043019",
            "telephone_number": "860-617-7719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 LAKE OTIS PKWY",
            "address_2": "SUITE 201",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085223",
            "telephone_number": "860-617-7719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNNACK",
        "first_name": "ANNIE",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-26",
        "last_updated": "2014-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AK",
            "license": "443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SP0049",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2014; 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.