The Alaska Shield Agency

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

License

723449 Issued in AK

Legal business name

THE ALASKA SHIELD AGENCY

Practice address

11487 Nikolai Circle
Wasilla, AK 99654-8801

Phone

(907) 258-5665

NPI assigned

Dec 12, 2008

Organization subpart

No

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

Authorized official

Name

Martha BradleyNPI 1104951920

Title

Owner

Phone

(907) 258-5665

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Martha Bradley

  • Case Manager/Care Coordinator
  • Wasilla, AK
  • NPI 1104951920

  Case Management

  NPD (past) Authorized official

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

{
    "created_epoch": "1229040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229040000000",
    "number": "1477798825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 35 BOX 5475A",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996548801",
            "telephone_number": "907-258-5665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11487 NIKOLAI CIRCLE",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996548801",
            "telephone_number": "907-258-5665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ALASKA SHIELD AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-12",
        "last_updated": "2008-12-12",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-258-5665"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "AK",
            "license": "723449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIVISION OF SENIOR AND DISABLED SERVICES",
            "identifier": "CMG678",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Case Management Agency in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Case Management Agency in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2008; 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.