Atlas Medical Alaska LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

ATLAS MEDICAL ALASKA LLC

Practice address

3831 E Blue Lupine Dr Ste C
Wasilla, AK 99654-8461

Phone

(907) 215-4846

Fax

(907) 215-4847

NPI assigned

Sep 13, 2021

Last updated

Dec 30, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tyler Pace

Title

Director

Phone

(907) 215-4846

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

Locations

Practitioners 18

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.

• Brandie Nicole Banks, NP

  • Family Nurse Practitioner
  • Anchorage, AK
  • NPI 1588286850
  Medicare reassignment Care Compare group NPD
• Clinton Deaver, FNP-BC

  • Family Nurse Practitioner
  • Wasilla, AK
  • NPI 1033937115
  Medicare reassignment Care Compare group NPD
• Nathan Neves George, NP

  • Family Medicine Physician
  • Wasilla, AK
  • NPI 1134638141
  Medicare reassignment Care Compare group NPD
• Elizabeth Hesse, NURSE PRACTITIONER

  • Primary Care Nurse Practitioner
  • Wasilla, AK
  • NPI 1952058364
  Medicare reassignment Care Compare group NPD
• Terelle Nicole Sterling, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Wasilla, AK
  • NPI 1699638619
  Medicare reassignment Care Compare group NPD
• Shane Mozingo

  • Family Nurse Practitioner
  • North Logan, UT
  • NPI 1295347474

  AK

  Medicare reassignment Care Compare group NPD
• Margaret Maixner, ANP

  • Family Nurse Practitioner
  • Big Lake, AK
  • NPI 1467824359
  Medicare reassignment NPD
• Mark Lavon Jorgensen, M.S., P.T.

  • Physical Therapist
  • Paradise, UT
  • NPI 1578826947

  AK

  Medicare reassignment
• Jessica Andrew, CCC SLP

  • Speech-Language Pathologist
  • Wasilla, AK
  • NPI 1962111443
  NPD
• Timothy J Buffey, DO

  • Family Medicine Physician
  • Anchorage, AK
  • NPI 1164422663
  NPD
• Patricia B Payne, ANP

  • Nurse Practitioner
  • Wasilla, AK
  • NPI 1346776150
  NPD
• Katlyn Ann Ferguson, CF-SLP

  • Speech-Language Pathologist
  • Rio Rancho, NM
  • NPI 1962009829
  NPD

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

{
    "created_epoch": "1631491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735516800000",
    "number": "1376213207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 E BOGARD RD STE 228",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547185",
            "telephone_number": "907-215-4846",
            "fax_number": "907-215-4847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3831 E BLUE LUPINE DR STE C",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996548461",
            "telephone_number": "907-215-4846",
            "fax_number": "907-215-4847"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3501 Denali St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995034039",
            "country_code": "US",
            "telephone_number": "907-215-4846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ATLAS MEDICAL ALASKA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-13",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A",
        "authorized_official_last_name": "PACE",
        "authorized_official_first_name": "TYLER",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "907-215-4846"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ascent Treatment Counseling Services, LLC
• Andrew Ashton
• Dustin Ates
• Atlas Chiropractic
• Atlas Medical Aco LLC
• Debra Janine Aubert, IBCLC
• Christina Aubrey
• Korey Aubrey
• Alyssa Michelle Auldridge
• Aumavae Cares LLC

• Internal Medicine Physician in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Internal Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; 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.