Full Spectrum Health, LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

FULL SPECTRUM HEALTH, LLC

Practice address

307 E Northern Lights Blvd Ste 201
Anchorage, AK 99503-2701

Phone

(907) 229-9766

Fax

(888) 974-0807

NPI assigned

Nov 20, 2017

Last updated

Nov 20, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tracey Wiese, ANP

Title

Owner

Phone

(907) 727-4239

Specialties & licenses 1

Addresses

Other identifiers 1

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19428/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1511136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511136000000",
    "number": "1407360977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 E NORTHERN LIGHTS BLVD STE 201",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995032701",
            "telephone_number": "907-229-9766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 E NORTHERN LIGHTS BLVD STE 201",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995032701",
            "telephone_number": "907-229-9766",
            "fax_number": "888-974-0807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL SPECTRUM HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-20",
        "last_updated": "2017-11-20",
        "status": "A",
        "authorized_official_last_name": "WIESE",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-727-4239",
        "authorized_official_credential": "ANP"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1022312",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Mark Fugett, LPC
• Terance Fuiava
• Fulani Alh
• Christina Fulcher
• Full Moon Fertility and Reproduction LLC
• Full Spectrum Pediatrics, PC
• Erin K Full, RD
• Fuller Diagnostics, LLC
• Jayme Fuller, PA-C
• Kristi H Fuller, PHD, ABPP-CN

• Multi-Specialty Clinic/Center in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Multi-Specialty Clinic/Center in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2017; 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.