Individual provider Active NPI

Kelly Tschida, NP-C

  • Family Nurse Practitioner
  • Anchorage, AK
National Provider Identifier
1346564200
Registry record updated Oct 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1142 Issued in AK
Practice address
4951 Business Park Blvd
Anchorage, AK 99503
Phone
(907) 743-7200
NPI assigned
Mar 22, 2010
Last updated
Oct 11, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP 60128758 WA
Family Nurse Practitioner 363LF0000X 1142 AK Primary

Addresses

Primary practice location

4951 Business Park Blvd
Anchorage, AK 99503

Mailing address

4951 Business Park Blvd
Anchorage, AK 99503-7174
Phone (907) 743-7200

Other practice location 1

4315 Diplomacy Dr
Anchorage, AK 99508-5926
Phone (800) 478-3343

Other practice location 2

4315 Diplomacy Dr
Anchorage, AK 99508-5926
Phone (800) 478-3343

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1142AKMDClinical Social Worker
AP 60128758WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cable & McCormick Apc Past Accepting new patients
Rehabilitation Medicine Associates PastSince Aug 1, 2002 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1269216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570752000000",
    "number": "1346564200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4951 BUSINESS PARK BLVD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995037174",
            "telephone_number": "907-743-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4951 BUSINESS PARK BLVD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "99503",
            "telephone_number": "907-743-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4315 Diplomacy Dr",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995085926",
            "country_code": "US",
            "telephone_number": "800-478-3343",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4315 Diplomacy Dr",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995085926",
            "country_code": "US",
            "telephone_number": "800-478-3343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TSCHIDA",
        "first_name": "KELLY",
        "name_prefix": "Mr.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-22",
        "last_updated": "2019-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP 60128758",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "1142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.