NPIMap

Individual provider Active NPI

Wendy Smith, P.A.-C

  • Medical Physician Assistant
  • Juneau, AK
National Provider Identifier
1306866561
Registry record updated Jun 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
599 Issued in AK
Practice address
10301 Glacier Hwy
Juneau, AK 99801-8561
Phone
(907) 789-2910
Fax
(907) 789-5545
NPI assigned
Jul 20, 2006
Last updated
Jun 27, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 599 AK Primary

Addresses

Primary practice location

10301 Glacier Hwy
Juneau, AK 99801-8561

Mailing address

10301 Glacier Hwy
Juneau, AK 99801-8561
Phone (907) 789-2910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080630000453 AK Practitioner - Physician Assistant 6305918707 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southeast Urgent Care IncorporatedGroup PAC ID 7012913155, 3 clinicians

Practice addresses (Care Compare)

8505 Old Dairy Rd
Juneau, AK 99801-6921
Phone (907) 790-4111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
599AKMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bartlett Regional Hospital Current Accepting new patients

Locations

10301 Glacier Hwy
Juneau, AK 99801
Phone (907) 789-2910

3260 Hospital Dr
Juneau, AK 99801
Phone (907) 796-8427

Interoperability endpoints

  • Direct secure messaging: wendy.smith.1@22880.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 37

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

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372291200000",
    "number": "1306866561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10301 GLACIER HWY",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998018561",
            "telephone_number": "907-789-2910",
            "fax_number": "907-789-5545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10301 GLACIER HWY",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998018561",
            "telephone_number": "907-789-2910",
            "fax_number": "907-789-5545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "WENDY",
        "name_prefix": "Mrs.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2013-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AK",
            "license": "599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Juneau, AK

Sources for this page

Verify at the official NPI Registry.