Jodi L Danter, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1076358

Practice address

5955 Zeamer Ave
673 Med Group/Sgcub
Elmendorf Afb, AK 99506-3702

Phone

(907) 580-1571

Fax

(907) 580-1575

NPI assigned

Feb 12, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jodi L Reitz Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386633600000",
    "number": "1619019452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5955 ZEAMER AVE",
            "address_2": "673 MED GROUP/SGCUB",
            "city": "ELMENDORF AFB",
            "state": "AK",
            "postal_code": "995063702",
            "telephone_number": "907-580-1571",
            "fax_number": "907-580-1575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5955 ZEAMER AVE",
            "address_2": "673 MED GROUP/SGCUB",
            "city": "ELMENDORF AFB",
            "state": "AK",
            "postal_code": "995063702",
            "telephone_number": "907-580-1571",
            "fax_number": "907-580-1575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANTER",
        "first_name": "JODI",
        "middle_name": "L",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2013-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": "1076358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JODI",
            "last_name": "REITZ",
            "middle_name": "L",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ava Brodie Craig, CCC-SLP
• Joshuah Patrick Cummings
• Jorey Alan Cunico, DO
• Ashley Dalessandro, PA-C
• Adam H Dalgleish, CRNA
• Betsy Lynne Demay, WHNP
• Herman Roy Ellemberger, M.D.
• Spring Ruth Ellemberger, M.D.
• Alex Raymond Fisher
• Nathaniel Arthur Foster, OD

• Physician Assistant in Elmendorf Afb, AK
• Providers in Elmendorf Afb, AK by specialty
• Physician Assistant in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.