Individual provider Active NPI

Carmen Botros Rizkalla

  • Registered Nurse
  • Anchorage, AK
National Provider Identifier
1376197061
Registry record updated Jul 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
139513 Issued in AK
Practice address
1650 Bragaw St
Anchorage, AK 99508-3435
Phone
(907) 433-7320
Fax
(907) 274-6413
NPI assigned
Jul 31, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 139513 AK Primary

Addresses

Primary practice location

1650 Bragaw St
Anchorage, AK 99508-3435

Mailing address

1650 South Bragaw
Anchorage, AK 99508-3435
Phone (907) 433-7320

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
139513AKMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1564531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1376197061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 SOUTH BRAGAW",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995083435",
            "telephone_number": "907-433-7320",
            "fax_number": "907-274-6413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 BRAGAW ST",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995083435",
            "telephone_number": "907-433-7320",
            "fax_number": "907-274-6413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIZKALLA",
        "first_name": "CARMEN",
        "middle_name": "BOTROS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-31",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AK",
            "license": "139513",
            "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 Jul 31, 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.