Individual provider Active NPI

Anna Altair, D.C.

  • Chiropractor
  • Wasilla, AK
National Provider Identifier
1255523015
Registry record updated Dec 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
417 Issued in AK
Practice address
452 S Knik Goose Bay Rd
Wasilla, AK 99654-8059
Phone
(907) 357-1818
Fax
(907) 357-1814
NPI assigned
Aug 15, 2007
Last updated
Dec 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 27004 CA
Chiropractor 111N00000X 417 AK Primary

Addresses

Primary practice location

452 S Knik Goose Bay Rd
Wasilla, AK 99654-8059

Mailing address

3161 E Palmer Wasilla Hwy
Ste 1C
Wasilla, AK 99654-7271
Phone (907) 357-1818

Other identifiers 2

IdentifierTypeStateIssuer
1225272594OtherAKNPI - ORGANIZATION
1255523015OtherAKNPI - INDIVIDUAL

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
417AKMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Altair Integrative Wellness CurrentSince Dec 15, 2019 Accepting new patients
Dopanine LLC PastSince Dec 15, 2019 Accepting new patients

Locations

3161 E Palmer Wasilla Hwy
Ste 1C
Wasilla, AK 99654
Phone (907) 357-1818

Organizations & group practices 2

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": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1255523015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3161 E PALMER WASILLA HWY",
            "address_2": "STE 1C",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547271",
            "telephone_number": "907-357-1818",
            "fax_number": "907-357-1814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "452 S KNIK GOOSE BAY RD",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996548059",
            "telephone_number": "907-357-1818",
            "fax_number": "907-357-1814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTAIR",
        "first_name": "ANNA",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-15",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "27004",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AK",
            "license": "417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI - ORGANIZATION",
            "identifier": "1225272594",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI - INDIVIDUAL",
            "identifier": "1255523015",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Dec 11, 2019; 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.