Individual provider Active NPI

Catherine Liddelow-Thompson, ANP

  • Family Nurse Practitioner
  • Anchorage, AK
National Provider Identifier
1629140629
Registry record updated Feb 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
411 Issued in AK
Practice address
2841 Debarr Rd Ste 25
Anchorage, AK 99508-2967
Phone
(907) 336-3500
Fax
(907) 264-2336
NPI assigned
Nov 14, 2006
Last updated
Feb 26, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 411 AK Primary

Addresses

Primary practice location

2841 Debarr Rd Ste 25
Anchorage, AK 99508-2967

Mailing address

2841 Debarr Rd Ste 25
Anchorage, AK 99508-2967
Phone (907) 336-3500

Other identifiers 1

IdentifierTypeStateIssuer
NP14021MedicaidAK

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050512000709 AK Practitioner - Nurse Practitioner 0345281077

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health and Wellness Inc. Family CurrentSince Oct 1, 2007 Accepting new patients
Susan Canafax, FNP PastSince Apr 1, 2012 Accepting new patients

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203984000000",
    "number": "1629140629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2841 DEBARR RD STE 25",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082967",
            "telephone_number": "907-336-3500",
            "fax_number": "907-264-2336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2841 DEBARR RD STE 25",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082967",
            "telephone_number": "907-336-3500",
            "fax_number": "907-264-2336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIDDELOW-THOMPSON",
        "first_name": "CATHERINE",
        "name_prefix": "Ms.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2008-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP14021",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.