NPIMap

Organization Active NPI

Advanced Telepsychiatry of Alaska LLC

  • Adult Mental Health Clinic/Center
  • Eagle River, AK
National Provider Identifier
1609467364
Registry record updated Jan 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
ADVANCED TELEPSYCHIATRY OF ALASKA LLC
Practice address
11470 Business Blvd
Eagle River, AK 99577-7780
Phone
(907) 406-6690
NPI assigned
Jan 26, 2021
Last updated
Jan 26, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2021

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

Authorized official

Name
Dr. Amber Virden, DNP, ANP-BC, PMHNP
Title
Aprn
Phone
(907) 406-6690

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X NU Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU

Addresses

Primary practice location

11470 Business Blvd
Eagle River, AK 99577-7780

Mailing address

PO Box 770824
Eagle River, AK 99577-0824
Phone (907) 406-6690

Other practice location 1

10943 Splendor Loop
Eagle River, AK 99577-8198
Phone (907) 406-6690

National Provider Directory

National Provider Directory

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.

NPI Registry JSON

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

{
    "created_epoch": "1611619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611619200000",
    "number": "1609467364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 770824",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995770824",
            "telephone_number": "907-406-6690",
            "fax_number": "907-726-0336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11470 BUSINESS BLVD",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777780",
            "telephone_number": "907-406-6690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10943 Splendor Loop",
            "address_purpose": "LOCATION",
            "city": "Eagle River",
            "state": "AK",
            "postal_code": "995778198",
            "country_code": "US",
            "telephone_number": "907-406-6690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADVANCED TELEPSYCHIATRY OF ALASKA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-26",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A",
        "authorized_official_last_name": "VIRDEN",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "APRN",
        "authorized_official_telephone_number": "907-406-6690",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, ANP-BC, PMHNP"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle River, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; 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.