Individual provider Active NPI

Tamara Deschaine

  • Registered Dietitian
  • Anchorage, AK
National Provider Identifier
1619424314
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
103477 Issued in AK
Practice address
4951 Business Park Blvd
Anchorage, AK 99503-7174
Phone
(907) 743-7200
NPI assigned
Sep 9, 2016
Last updated
May 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 103477 AK Primary

Addresses

Primary practice location

4951 Business Park Blvd
Anchorage, AK 99503-7174

Mailing address

4951 Business Park Blvd
Anchorage, AK 99503-7174
Phone (907) 743-7200

Other practice location 1

12240 Woodchase Cir
Anchorage, AK 99516-2051
Phone (907) 351-0471

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200227002157 AK Practitioner - Registered Dietitian Or Nutrition Professional 4486081650 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
103477AKMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Anchorage Neighborhood Health Center, Inc. CurrentSince Feb 1, 2020 Accepting new patients
Anchorage Neighborhood Health Center Inc CurrentSince Feb 1, 2020 Accepting new patients

Locations

4951 Business Park Blvd
Anchorage, AK 99503
Phone (907) 743-7200

Organizations & group practices 2

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": "1473379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1619424314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4951 BUSINESS PARK BLVD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995037174",
            "telephone_number": "907-743-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4951 BUSINESS PARK BLVD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995037174",
            "telephone_number": "907-743-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12240 Woodchase Cir",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995162051",
            "country_code": "US",
            "telephone_number": "907-351-0471",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESCHAINE",
        "first_name": "TAMARA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-09",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AK",
            "license": "103477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.