Individual provider Active NPI

Ann Victoria Andrus

  • Peer Specialist
  • Wasilla, AK
National Provider Identifier
1396354544
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
1363 W Spruce Ave
Wasilla, AK 99654-5327
Phone
(907) 376-2411
NPI assigned
Jul 23, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mat - Su Health Services Inc. CurrentSince Aug 2, 2020 Accepting new patients

Locations

425 E Dahlia Ave
Ste M
Palmer, AK 99645
Phone (907) 376-2411

1363 W Spruce Ave
Wasilla, AK 99654
Phone (907) 376-2411

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X AK Primary

Addresses

Primary practice location

1363 W Spruce Ave
Wasilla, AK 99654-5327

Mailing address

1363 W Spruce Ave
Wasilla, AK 99654-5327
Phone (907) 376-2411

Other practice location 1

3261 S Big Lake Rd
Big Lake, AK 99623-9663
Phone (907) 376-2411

Other practice location 2

425 E Dahlia Ave Ste M
Palmer, AK 99645-6463
Phone (907) 376-2411

NPI Registry JSON

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

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1396354544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1363 W SPRUCE AVE",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996545327",
            "telephone_number": "907-376-2411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1363 W SPRUCE AVE",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996545327",
            "telephone_number": "907-376-2411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3261 S Big Lake Rd",
            "address_purpose": "LOCATION",
            "city": "Big Lake",
            "state": "AK",
            "postal_code": "996239663",
            "country_code": "US",
            "telephone_number": "907-376-2411",
            "fax_number": "907-352-3363",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "425 E Dahlia Ave Ste M",
            "address_purpose": "LOCATION",
            "city": "Palmer",
            "state": "AK",
            "postal_code": "996456463",
            "country_code": "US",
            "telephone_number": "907-376-2411",
            "fax_number": "907-352-3363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDRUS",
        "first_name": "ANN",
        "middle_name": "VICTORIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-23",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "AK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; 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.