Individual provider Active NPI

Elisabeth Manet Jones

  • Women's Health Nurse Practitioner
  • Wasilla, AK
National Provider Identifier
1659146074
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
217148 Issued in AK
Practice address
3122 E Meridian Park Loop
Wasilla, AK 99654-7255
Phone
(907) 357-1113
Fax
(907) 357-9593
NPI assigned
Nov 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Intensive Care Registered Nurse 163WN0002X 137133 AK
Women's Health Nurse Practitioner 363LW0102X 217148 AK Primary

Addresses

Primary practice location

3122 E Meridian Park Loop
Wasilla, AK 99654-7255

Mailing address

1736 Logan St
Anchorage, AK 99508-3240
Phone (401) 743-0186

Other practice location 1

1736 Logan St
Anchorage, AK 99508-3240
Phone (401) 743-0186

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
I20240307003332 AK Practitioner - Nurse Practitioner 5395181713 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
137133AKMDNeonatal Intensive Care Registered Nurse
217148AKMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Network of Alaska, LLC Current Accepting new patients
Medical Network of Alaska, LLC CurrentSince Mar 1, 2024 Accepting new patients
Medical Network of Alaska, LLC Current Accepting new patients
Medical Network of Alaska, LLC CurrentSince Mar 1, 2024 Accepting new patients
Mat-Su Valley Medical Center LLC Past Accepting new patients
Medical Network of Alaska, LLC Past Accepting new patients

Locations

3331 E Meridian Park Loop
Wasilla, AK 99654
Phone (907) 357-2332

3122 E Meridian Park Loop
Wasilla, AK 99654
Phone (907) 864-4625

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1700006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1659146074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1736 LOGAN ST",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995083240",
            "telephone_number": "401-743-0186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3122 E MERIDIAN PARK LOOP",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547255",
            "telephone_number": "907-357-1113",
            "fax_number": "907-357-9593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1736 Logan St",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995083240",
            "country_code": "US",
            "telephone_number": "401-743-0186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "ELISABETH",
        "middle_name": "MANET",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-15",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "AK",
            "license": "137133",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "AK",
            "license": "217148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

Verify at the official NPI Registry.