NPIMap

Organization Active NPI

Kabo Health LLC

Doing business as Mountain View Urgent Care

  • Urgent Care Clinic/Center
  • Anchorage, AK
National Provider Identifier
1346777505
Registry record updated Nov 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
License
1048438 Issued in AK
Legal business name
KABO HEALTH LLC
Doing business as
Mountain View Urgent Care
Practice address
3521 Mountain View Dr
Anchorage, AK 99508-1111
Phone
(805) 766-1049
NPI assigned
May 18, 2017
Last updated
Nov 10, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2023

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

Authorized official

Name
Jonathan Mark Vanravenswaay, MDNPI 1154768588
Title
Managing Member
Phone
(805) 766-1049

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 111160 AK
Urgent Care Clinic/Center 261QU0200X 1048438 AK Primary

Addresses

Primary practice location

3521 Mountain View Dr
Anchorage, AK 99508-1111

Mailing address

3521 Mountain View Dr
Anchorage, AK 99508-1111
Phone (805) 766-1049

Other names 1

  • Mountain View Urgent Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180801003565 AK Part B Supplier - Clinic/Group Practice 5193073542 Receives reassigned benefits from 3 practitioners
Practice locations: Anchorage, AK

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1495065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699574400000",
    "number": "1346777505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3521 MOUNTAIN VIEW DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995081111",
            "telephone_number": "805-766-1049",
            "fax_number": "907-868-1105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3521 MOUNTAIN VIEW DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995081111",
            "telephone_number": "805-766-1049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KABO HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-18",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-09",
        "status": "A",
        "authorized_official_last_name": "VANRAVENSWAAY",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "805-766-1049",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "111160",
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "AK",
            "license": "1048438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain View Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mountain View Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 10, 2023; 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.