NPIMap

Organization Active NPI

Nor-Alaska Physical Therapy, LLC

Doing business as Eagle Center Physical Therapy

  • Physical Therapist
  • Eagle River, AK
National Provider Identifier
1326586348
Registry record updated Feb 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1048322 Issued in AK
Legal business name
NOR-ALASKA PHYSICAL THERAPY, LLC
Doing business as
Eagle Center Physical Therapy
Practice address
11470 Business Blvd
Suite 200
Eagle River, AK 99577-7780
Phone
(907) 696-5678
Fax
(907) 696-2248
NPI assigned
Feb 9, 2017
Last updated
Feb 24, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2017

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

Authorized official

Name
Boerre H Brevik, PTNPI 1497808828
Title
Owner
Phone
(907) 696-5678

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X 1048322 AK Primary

Addresses

Primary practice location

11470 Business Blvd
Suite 200
Eagle River, AK 99577-7780

Mailing address

11470 Business Blvd
Suite 200
Eagle River, AK 99577-7780
Phone (907) 696-5678

Other names 1

  • Eagle Center Physical Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170222002922 AK Part B Supplier - Clinic/Group Practice 7214211036 Receives reassigned benefits from 10 practitioners
Practice locations: Eagle River, AK

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1486598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487894400000",
    "number": "1326586348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11470 BUSINESS BLVD",
            "address_2": "SUITE 200",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777780",
            "telephone_number": "907-696-5678",
            "fax_number": "907-696-2248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11470 BUSINESS BLVD",
            "address_2": "SUITE 200",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777780",
            "telephone_number": "907-696-5678",
            "fax_number": "907-696-2248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOR-ALASKA PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-09",
        "last_updated": "2017-02-24",
        "status": "A",
        "authorized_official_last_name": "BREVIK",
        "authorized_official_first_name": "BOERRE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-696-5678",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "1048322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eagle Center Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eagle River, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.