Peninsula Neurology LLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

4795 Issued in AK

Legal business name

PENINSULA NEUROLOGY LLC

Practice address

206 W Rockwell Ave
Ste 100
Soldotna, AK 99669-7411

Phone

(907) 262-7700

Fax

(907) 262-0809

NPI assigned

Aug 27, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Kristen Jessen, M.D., PHD

Title

Physician

Phone

(907) 262-7700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Alyeska Neurology Doing business as

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

{
    "created_epoch": "1219795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219795200000",
    "number": "1376791707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 W ROCKWELL AVE",
            "address_2": "STE 100",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697411",
            "telephone_number": "907-262-7700",
            "fax_number": "907-262-0809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 W ROCKWELL AVE",
            "address_2": "STE 100",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697411",
            "telephone_number": "907-262-7700",
            "fax_number": "907-262-0809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA NEUROLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-27",
        "last_updated": "2008-08-27",
        "status": "A",
        "authorized_official_last_name": "JESSEN",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "907-262-7700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., PHD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AK",
            "license": "4795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD0369",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alyeska Neurology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Peninsula Health Center Inc.
• Peninsula Health Center, Inc
• Peninsula Hearing Services, Inc.
• Peninsula Instacare
• Peninsula Internal Medicine PC
• Peninsula Preferred Home Health Corp
• Peninsula Surgical Solutions, LLC
• Pedro E Perez, M.D.
• Charles George Perkins, MD
• Lyla Annette Perkins

• Neurology Physician in Soldotna, AK
• Providers in Soldotna, AK by specialty
• Neurology Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2008; 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.