Active NPI
Pacific Pediatrics, LLC
- Primary Care Clinic/Center
- Craig, AK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- Legal business name
- PACIFIC PEDIATRICS, LLC
- Practice address
- 602 JS St
Unit#1
Craig, AK 99921-9992 - Phone
- (313) 300-8189
- Fax
- (833) 887-4972
- NPI assigned
- Oct 15, 2018
- Last updated
- May 12, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Elisa Marie Rosier, MD
- Title
- Pediatrician/Owner
- Phone
- (313) 300-8189
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | NU | Primary |
Addresses
Primary practice location
602 JS St
Unit#1
Craig, AK 99921-9992
Mailing address
PO Box 181
Craig, AK 99921-0181
Phone (313) 300-8189
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1009328 | Medicaid | AK |
National Provider Directory
National Provider Directory- Tax ID family
- Pacific Pediatrics LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Pediatrics Physician
- Ketchikan, AK
- NPI 1629543046
Locations
3137 Tongass Ave
#C
Ketchikan, AK 99901
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.
-
- Pediatrics Physician
- Ketchikan, AK
- NPI 1790996916
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539561600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1652313600000",
"number": "1477029767",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 181",
"city": "CRAIG",
"state": "AK",
"postal_code": "999210181",
"telephone_number": "313-300-8189",
"fax_number": "833-887-4972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "602 JS ST",
"address_2": "UNIT#1",
"city": "CRAIG",
"state": "AK",
"postal_code": "999219992",
"telephone_number": "313-300-8189",
"fax_number": "833-887-4972"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PACIFIC PEDIATRICS, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-10-15",
"last_updated": "2022-05-12",
"certification_date": "2022-04-26",
"status": "A",
"authorized_official_last_name": "ROSIER",
"authorized_official_first_name": "ELISA",
"authorized_official_middle_name": "MARIE",
"authorized_official_title_or_position": "PEDIATRICIAN/OWNER",
"authorized_official_telephone_number": "313-300-8189",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1009328",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Craig, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.