Individual provider Active NPI

Charlot K Pierce, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Anchorage, AK
National Provider Identifier
1639909567
Registry record updated Aug 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
227048 Issued in AK
Practice address
2600 Denali St Ste 300
Anchorage, AK 99503-2746
Phone
(907) 318-9050
Fax
(907) 202-5565
NPI assigned
Aug 6, 2024
Last updated
Aug 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 227048 AK Primary

Addresses

Primary practice location

2600 Denali St Ste 300
Anchorage, AK 99503-2746

Mailing address

PO Box 230756
Anchorage, AK 99523-0756
Phone (907) 318-9050

Other names 1

  • Charlot K Main/Stallone Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240905004213 AK Practitioner - Nurse Practitioner 5193265072 Reassigns benefits to 1 organization
I20241031000280 TX Practitioner - Nurse Practitioner 5193265072 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alaska Compass LLCGroup PAC ID 2062809957, 3 clinicians

Practice addresses (Care Compare)

1131 E International Airport Rd
Anchorage, AK 99518-1408
Phone (907) 276-2700

2600 Denali St
Suite 300
Anchorage, AK 99503-2746
Phone (907) 318-9050

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
227048AKMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aleutian Pribilof Islands Association Inc CurrentSince Aug 16, 2024 Accepting new patients
Birch Tree Behavioral Health LLC Psychiatric/Mental Health CurrentSince Jul 25, 2024 Accepting new patients
Alaska Compass LLC Psychiatric/Mental Health CurrentSince Jul 25, 2024 Accepting new patients
Aleutian Pribilof Islands Assoc Inc CurrentSince Aug 16, 2024 Accepting new patients

Locations

1131 E Intl Airport Rd
Anchorage, AK 99518
Phone (907) 276-2700

2600 Denali St
Ste 300
Anchorage, AK 99503
Phone (907) 318-9050

Organizations & group practices 4

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": "1722902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724457600000",
    "number": "1639909567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 230756",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995230756",
            "telephone_number": "907-318-9050",
            "fax_number": "907-202-5565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 DENALI ST STE 300",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995032746",
            "telephone_number": "907-318-9050",
            "fax_number": "907-202-5565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERCE",
        "first_name": "CHARLOT",
        "middle_name": "K",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-06",
        "last_updated": "2024-08-24",
        "certification_date": "2024-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AK",
            "license": "227048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLOT",
            "last_name": "MAIN/STALLONE",
            "middle_name": "K",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.