Individual provider Active NPI

Judith Whitcomb, M.D.

  • Specialist
  • Anchorage, AK
National Provider Identifier
1336225291
Registry record updated Oct 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1697 Issued in AK
Practice address
3300 Providence Dr
Suite 108
Anchorage, AK 99508-4616
Phone
(907) 563-3028
Fax
(907) 563-0236
NPI assigned
Oct 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 1697 AK Primary

Addresses

Primary practice location

3300 Providence Dr
Suite 108
Anchorage, AK 99508-4616

Mailing address

6963 Lovitt Cir
Anchorage, AK 99507-6749
Phone (907) 563-3028

Other identifiers 1

IdentifierTypeStateIssuer
MD1697MedicaidAK

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100302000744 AK Practitioner - General Surgery 6305981333 Practice locations: Anchorage, AK

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1697AKMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192579200000",
    "number": "1336225291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6963 LOVITT CIR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995076749",
            "telephone_number": "907-563-3028",
            "fax_number": "907-563-0236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 PROVIDENCE DR",
            "address_2": "SUITE 108",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084616",
            "telephone_number": "907-563-3028",
            "fax_number": "907-563-0236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITCOMB",
        "first_name": "JUDITH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2007-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AK",
            "license": "1697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD1697",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.