Ellen Dee Faucett, D.O.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

2698 Issued in AK

Practice address

3505 E Meridian Park Loop Ste 100
Wasilla, AK 99654-7242

Phone

(907) 357-4963

NPI assigned

Jan 24, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mat-Su Birth Center, LLC

  • Birthing Clinic/Center
  • Wasilla, AK
  • NPI 1629137799
  NPD (past)
• Mat-Su Valley Medical Center LLC

  • General Acute Care Hospital
  • Palmer, AK
  • NPI 1417975061
  NPD (past)

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1386799658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 E MERIDIAN PARK LOOP STE 100",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547242",
            "telephone_number": "907-746-5305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 E MERIDIAN PARK LOOP STE 100",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547242",
            "telephone_number": "907-357-4963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAUCETT",
        "first_name": "ELLEN",
        "middle_name": "DEE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AK",
            "license": "2698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD0203",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Far North Care, LLC
• Andrea Farmer, APRN
• Eric Brinton Farnsworth
• Cynthia Farrens
• Debbie Lynn Farris
• Amanda Marie Fedewa
• Liudmila Fedor, FNP-C
• Rebecca Felch
• Lisa Feltz, M.A. CCC-SLP
• Desiree Feringa

• Obstetrics & Gynecology Physician in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Obstetrics & Gynecology Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; 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.