Urgent Care at Lake Lucille Inc

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

License

3064 Issued in AK

Legal business name

URGENT CARE AT LAKE LUCILLE INC

Practice address

185 E Parks Hwy
Wasilla, AK 99654-7038

Phone

(907) 373-4203

Fax

(907) 373-4201

NPI assigned

May 20, 2006

Last updated

Apr 21, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Ellen R Varosi

Title

Financial Officer

Phone

(907) 373-4200

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Louis M Packer, M.D.

  • Family Medicine Physician
  • Wasilla, AK
  • NPI 1407965288
  Medicare reassignment Care Compare group NPD
• Michelle Leiolani Vanderpool, FNP

  • Nurse Practitioner
  • Wasilla, AK
  • NPI 1477224426

  Urgent Care

  Medicare reassignment Care Compare group NPD
• Richard W. Blake, PA-C

  • Medical Physician Assistant
  • Wasilla, AK
  • NPI 1740235829
  Medicare reassignment Care Compare group
• Christi M. Angelo, APRN

  • Family Nurse Practitioner
  • Wasilla, AK
  • NPI 1902955891
  Medicare reassignment NPD
• Nathan Neves George, NP

  • Family Medicine Physician
  • Wasilla, AK
  • NPI 1134638141
  Medicare reassignment NPD
• Norvin Perez, MD

  • Emergency Medicine Physician
  • Juneau, AK
  • NPI 1346235819
  Medicare reassignment NPD
• Robert L Rosentreter III, FNP-C

  • Family Nurse Practitioner
  • Fairbanks, AK
  • NPI 1780340851
  Medicare reassignment NPD
• Tamara Simpson, ANP

  • Nurse Practitioner
  • Wasilla, AK
  • NPI 1881128643
  Medicare reassignment NPD
• Shaina Elaine Ahles, PA-C

  • Medical Physician Assistant
  • Talkeetna, AK
  • NPI 1518500347
  Medicare reassignment
• Richard Thomas Combs, PA-C

  • Physician Assistant
  • Tok, AK
  • NPI 1972984037
  Medicare reassignment
• Ashley F Marquardt, PAC

  • Physician Assistant
  • Anchorage, AK
  • NPI 1427019587
  Medicare reassignment
• John Wayne Moore, PA-C

  • Medical Physician Assistant
  • Wasilla, AK
  • NPI 1669552550
  Medicare reassignment

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776729600000",
    "number": "1275587768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 E PARKS HWY",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547038",
            "telephone_number": "907-373-4203",
            "fax_number": "907-373-4201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 E PARKS HWY",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547038",
            "telephone_number": "907-373-4203",
            "fax_number": "907-373-4201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "URGENT CARE AT LAKE LUCILLE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A",
        "authorized_official_last_name": "VAROSI",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "FINANCIAL OFFICER",
        "authorized_official_telephone_number": "907-373-4200",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "3064",
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "AK",
            "license": "3064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zoey Ulrick
• Christa Underwood, MPC
• Upekkha Wellness, LLC
• Blaine G Upham, DC
• Lonnie Urban, LMT
• Marc Uscola
• Utopia LLC
• John F. Vachal, P.T.
• Colin Valdez, L.M.T.
• Valley Care Coordination (Desiree Ortega)

• Urgent Care Clinic/Center in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Urgent Care Clinic/Center in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; 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.