Active NPI
Ann Victoria Andrus
- Peer Specialist
- Wasilla, AK
National Provider Identifier
1396354544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Wasilla, AK
- NPI 1184725210
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mat - Su Health Services Inc. | Current | 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
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
{
"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.