Surgical Specialists of Alaska LLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

10024226 Issued in AK

Legal business name

SURGICAL SPECIALISTS OF ALASKA LLC

Practice address

1690 W Pipestone Dr
Wasilla, AK 99654-9741

Phone

(907) 230-3734

Fax

(866) 525-8738

NPI assigned

Sep 17, 2014

Organization subpart

No

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

Authorized official

Name

Kerre Shelton

Title

Operations Administrator

Phone

(907) 748-7398

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525651200000",
    "number": "1265834782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5432 E NORTHERN LIGHTS BLVD # 510",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084713",
            "telephone_number": "907-230-3734",
            "fax_number": "866-525-8738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 W PIPESTONE DR",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996549741",
            "telephone_number": "907-230-3734",
            "fax_number": "866-525-8738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL SPECIALISTS OF ALASKA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-17",
        "last_updated": "2018-05-07",
        "status": "A",
        "authorized_official_last_name": "SHELTON",
        "authorized_official_first_name": "KERRE",
        "authorized_official_title_or_position": "OPERATIONS ADMINISTRATOR",
        "authorized_official_telephone_number": "907-748-7398"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "AK",
            "license": "10024226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUSINESS LICENSE",
            "identifier": "1002426",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sunrise Assisted Living
• Sunrise House Assisted Living Home II (Sunrise House)
• Sunshine Community Health Center, Inc
• Sunshine Community Health Center, Inc.
• Surgery Center of Wasilla, LLC
• Susan K Miller
• Susan Reed
• Susitna Mediset Services Inc (Susitna Mediset Services)
• Susitna Professional Pharmacy
• Callum Patrick Sutherland, DPT

• Orthopaedic Surgery Physician in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Orthopaedic Surgery Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2018; 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.