Organization Active NPI

White Skye Summit LLC

  • Family Medicine Physician
  • Wasilla, AK
National Provider Identifier
1205035573
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2726 Issued in AK
Legal business name
WHITE SKYE SUMMIT LLC
Practice address
2851 E Palmer Wasilla Hwy Ste 3
Wasilla, AK 99654-7499
Phone
(907) 357-7944
Fax
(907) 357-7991
NPI assigned
Jul 16, 2007
Organization subpart
Yes
Parent organization
WHITE SKYE SUMMIT LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 7, 2024

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

Authorized official

Name
Rebecca SC White, MDNPI 1205843430
Title
Owner/Member
Phone
(907) 357-7944

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 2726 AK Primary

Addresses

Primary practice location

2851 E Palmer Wasilla Hwy Ste 3
Wasilla, AK 99654-7499

Mailing address

561 S Denali
Suite E
Palmer, AK 99645
Phone (907) 745-7944

Other identifiers 1

IdentifierTypeStateIssuer
2726OtherAKSTATE LICENSE

Other names 2

  • Arctic Skye Family Medicine Doing business as
  • Arctic Skye Family medicime Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070822000808 AK Part B Supplier - Clinic/Group Practice 8325130305 Receives reassigned benefits from 3 practitioners
Practice locations: Wasilla, AK

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
02D1073821Arctic Skye Family Medicine2851 E Palmer Wasilla Hwy, Ste 3, Wasilla, AK 99654Certificate of waiverSep 16, 2027

National Provider Directory

National Provider Directory
Part of
White Skye Summit LLC

Locations

2851 E Palmer Wasilla Hwy
Wasilla, AK 99654

2851 E Palmer Wasilla Hwy
Ste 3
Wasilla, AK 99654
Phone (907) 357-7944

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717718400000",
    "number": "1205035573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "561 S DENALI",
            "address_2": "SUITE E",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "99645",
            "telephone_number": "907-745-7944",
            "fax_number": "907-745-7918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2851 E PALMER WASILLA HWY STE 3",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547499",
            "telephone_number": "907-357-7944",
            "fax_number": "907-357-7991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE SKYE SUMMIT LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WHITE SKYE SUMMIT LLC",
        "enumeration_date": "2007-07-16",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "SC",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "907-357-7944",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "2726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2726",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arctic Skye Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Arctic Skye Family medicime",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Arctic Skye Family medicime",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wasilla, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.