Individual provider Active NPI

Janine Paulette Stitt, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Anchorage, AK
National Provider Identifier
1265666366
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1124 Issued in AK
Practice address
4320 Diplomacy Dr
Suite #1500
Anchorage, AK 99508-5925
Phone
(907) 729-8607
NPI assigned
May 5, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 688757 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1124 AK Primary

Addresses

Primary practice location

4320 Diplomacy Dr
Suite #1500
Anchorage, AK 99508-5925

Mailing address

645 N. Jessica Brooke Circle
Suite F
Wasilla, AK 99654-5904
Phone (907) 376-9919

Other identifiers 3

IdentifierTypeStateIssuer
102236MedicaidAK
12743679OtherCAQH PROVIDER ID
NPO154MedicaidAK

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
688757TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southcentral Foundation PastSince Sep 5, 2023 Accepting new patients
Southcentral Foundation Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1241481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1265666366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 N. JESSICA BROOKE CIRCLE",
            "address_2": "SUITE F",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996545904",
            "telephone_number": "907-376-9919",
            "fax_number": "907-376-9911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 DIPLOMACY DR",
            "address_2": "SUITE #1500",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085925",
            "telephone_number": "907-729-8607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STITT",
        "first_name": "JANINE",
        "middle_name": "PAULETTE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-05",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "688757",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AK",
            "license": "1124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102236",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIDER ID",
            "identifier": "12743679",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NPO154",
            "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 Mar 7, 2023; 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.