Individual provider Active NPI

Maureen Northway, FNP-C

  • Family Nurse Practitioner
  • Ketchikan, AK
National Provider Identifier
1295912608
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1012 Issued in AK
Practice address
5534 North Tongass Highway
Ketchikan, AK 99901-5669
Phone
(907) 225-4325
Fax
(907) 531-7369
NPI assigned
Jan 28, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1012 AK Primary

Addresses

Primary practice location

5534 North Tongass Highway
Ketchikan, AK 99901-5669

Mailing address

5534 North Tongass Highway
Ketchikan, AK 99901-5669
Phone (907) 225-4325

Other identifiers 1

IdentifierTypeStateIssuer
1012OtherAKALASKA LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141216000001 AK Practitioner - Nurse Practitioner 4284701392 Practice locations: Ketchikan, AK

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5534 N Tongass Hwy
Ketchikan, AK 99901-9008
Phone (907) 225-4325

Hospital & facility affiliations

  • Peacehealth Ketchikan Medical Center Hospital, Ketchikan, AK, CCN 021311

Merit-based Incentive Payment System (MIPS)

Final score
79.12 of 100Reported as group
Quality
81.91
Promoting interoperability
100
Improvement activities
40
Cost
40.93

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northway Family Healthcare CurrentSince Nov 1, 2014 Accepting new patients

Locations

5534 N Tongass Hwy
Ketchikan, AK 99901
Phone (907) 225-4325

130 Carlanna Lake Rd
Ste 201
Ketchikan, AK 99901
Phone (907) 225-4325

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1295912608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5534 NORTH TONGASS HIGHWAY",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999015669",
            "telephone_number": "907-225-4325",
            "fax_number": "907-531-7369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5534 NORTH TONGASS HIGHWAY",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999015669",
            "telephone_number": "907-225-4325",
            "fax_number": "907-531-7369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORTHWAY",
        "first_name": "MAUREEN",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-28",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "1012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALASKA LICENSE",
            "identifier": "1012",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ketchikan, AK

Sources for this page

Verify at the official NPI Registry.