Individual provider Active NPI

Kerrie Rochelle Bossard, M.D.

  • Colon & Rectal Surgery Physician
  • Anchorage, AK
National Provider Identifier
1548267032
Registry record updated Jan 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
26798 Issued in NE
Practice address
2751 Debarr Rd
Suite 280
Anchorage, AK 99508-2952
Phone
(907) 222-1401
Fax
(907) 222-1402
NPI assigned
Jun 30, 2005
Last updated
Jan 2, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 35946 IA
Colon & Rectal Surgery Physician 208C00000X 26798 NE Primary
Surgery Physician 208600000X 8070 AK

Addresses

Primary practice location

2751 Debarr Rd
Suite 280
Anchorage, AK 99508-2952

Mailing address

2751 Debarr Rd
Suite 280
Anchorage, AK 99508-2952
Phone (907) 222-1401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140317000907 AK Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 0648200444 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
8070AKMDSurgery Physician
26798NEMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alaska Colorectal Surgery, PC Colon & Rectal Surgery CurrentSince Jan 1, 2014 Accepting new patients

Locations

2751 Debarr Rd
Ste 280
Anchorage, AK 99508
Phone (907) 222-1401

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388620800000",
    "number": "1548267032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2751 DEBARR RD",
            "address_2": "SUITE 280",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082952",
            "telephone_number": "907-222-1401",
            "fax_number": "907-222-1402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2751 DEBARR RD",
            "address_2": "SUITE 280",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082952",
            "telephone_number": "907-222-1401",
            "fax_number": "907-222-1402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSSARD",
        "first_name": "KERRIE",
        "middle_name": "ROCHELLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-30",
        "last_updated": "2014-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IA",
            "license": "35946",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NE",
            "license": "26798",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AK",
            "license": "8070",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.