Individual provider Active NPI

Mary Decourcey

  • Family Nurse Practitioner
  • Anchorage, AK
National Provider Identifier
1386060291
Registry record updated Mar 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1429 Issued in AK
Practice address
4100 Lake Otis Pkwy Ste 322
Anchorage, AK 99508-5231
Phone
(907) 562-1234
NPI assigned
Mar 16, 2014
Last updated
Mar 16, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1429 AK Primary

Addresses

Primary practice location

4100 Lake Otis Pkwy Ste 322
Anchorage, AK 99508-5231

Mailing address

4100 Lake Otis Pkwy Ste 322
Anchorage, AK 99508-5231

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150708001409 AK Practitioner - Nurse Practitioner 0143532952 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1429AKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Norton Sound Health Corporation CurrentSince Jun 24, 2024 Accepting new patients
Norton Sound Health Corporation Current Accepting new patients
Matt a. Heilala, DPM Inc. CurrentSince May 11, 2015 Accepting new patients
Norton Sound Health Corporation CurrentSince Jun 24, 2024 Accepting new patients
Matt a. Heilala, DPM Inc. CurrentSince May 11, 2015 Accepting new patients

Locations

3190 E Meridian Park Loop
Ste 205
Wasilla, AK 99654
Phone (907) 373-3338

Interoperability endpoints

  • Direct secure messaging: frontdesk@akfootankle.directbygreenway.com
  • FHIR API: https://api.platform.athenahealth.com/21331/brand/1/csg/1/fhir/r4
  • Direct secure messaging: mary.decourcey@265489250582532.direct.elationemr.com
  • Direct secure messaging: mrdecourcey@direct.nshcorp.org

Organizations & group practices 5

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": "1394928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394928000000",
    "number": "1386060291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 LAKE OTIS PKWY STE 322",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 LAKE OTIS PKWY STE 322",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085231",
            "telephone_number": "907-562-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECOURCEY",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-16",
        "last_updated": "2014-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "1429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.