Active NPI
Lori Landstrom, PA C
- Physician Assistant
- Seward, AK
National Provider Identifier
1316013998
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1346
- Practice address
- 201 3Rd Avenue
Suite 201
Seward, AK 99664-2088 - Phone
- (907) 224-3490
- Fax
- (907) 224-5870
- NPI assigned
- Nov 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1346 | AK | Primary |
Addresses
Primary practice location
201 3Rd Avenue
Suite 201
Seward, AK 99664-2088
Mailing address
PO Box 2088
Suite 201
Seward, AK 99664-2088
Phone (907) 224-3490
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CL3490 | Medicaid | AK |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 480 | AK | MD | Psychologist |
| 1346 | AK | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1316013998",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2088",
"address_2": "SUITE 201",
"city": "SEWARD",
"state": "AK",
"postal_code": "996642088",
"telephone_number": "907-224-3490",
"fax_number": "907-224-5870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 3RD AVENUE",
"address_2": "SUITE 201",
"city": "SEWARD",
"state": "AK",
"postal_code": "996642088",
"telephone_number": "907-224-3490",
"fax_number": "907-224-5870"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANDSTROM",
"first_name": "LORI",
"credential": "PA C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AK",
"license": "1346",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "CL3490",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Seward, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.