Charles Hurst Van Ravenswaay

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

851 E Westpoint Dr Ste 310
Wasilla, AK 99654-7183

Phone

(907) 357-5400

NPI assigned

May 7, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/citci/r4/

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.

• Cook Inlet Tribal Council, Inc

  • Community/Behavioral Health Agency
  • Anchorage, AK
  • NPI 1437273000
  NPD (past)
• Cook Inlet Tribal Council, Inc

  • Community/Behavioral Health Agency
  • Anchorage, AK
  • NPI 1952101362
  NPD (past)

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

{
    "created_epoch": "1557187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557187200000",
    "number": "1487219200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 SAN JERONIMO DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 E WESTPOINT DR STE 310",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547183",
            "telephone_number": "907-357-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN RAVENSWAAY",
        "first_name": "CHARLES",
        "middle_name": "HURST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-07",
        "last_updated": "2019-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valley Upright Imaging LLC
• Valley Vitality Wellness LLC
• Lorraine Linda Valli
• Valor Midwifery Services
• Katherine Grace Van Atta, PA-C, CNM
• Jessica D Van Wulven, PA-C
• Macy Vanbuskirk
• Tristan Shea Vandelac
• Susan Vander Martin, RN
• Joshua Vanderlooven

• All providers in Wasilla, AK
• Case Manager/Care Coordinator in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2019; 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.