NPIMap

Organization Active NPI

Haven Medical, LLC

  • Physician Assistant
  • Anchorage, AK
National Provider Identifier
1407306434
Registry record updated Oct 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
410 Issued in AK
Legal business name
HAVEN MEDICAL, LLC
Practice address
3340 Providence Dr
Ste 466
Anchorage, AK 99508-4691
Phone
(907) 263-2200
NPI assigned
Oct 13, 2016
Last updated
Oct 14, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2016

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

Authorized official

Name
Patricia Brown, PA-C, MSHSNPI 1588878532
Title
Owner/ Member
Phone
(907) 263-2200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 410 AK Primary

Addresses

Primary practice location

3340 Providence Dr
Ste 466
Anchorage, AK 99508-4691

Mailing address

3340 Providence Dr
Ste 466
Anchorage, AK 99508-4691
Phone (907) 263-2200

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1476316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476403200000",
    "number": "1407306434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 PROVIDENCE DR",
            "address_2": "STE 466",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084691",
            "telephone_number": "907-263-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 PROVIDENCE DR",
            "address_2": "STE 466",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084691",
            "telephone_number": "907-263-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-13",
        "last_updated": "2016-10-14",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "OWNER/ MEMBER",
        "authorized_official_telephone_number": "907-263-2200",
        "authorized_official_credential": "PA-C, MSHS"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2016; 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.