Jesse Atwood MD Pediatrics, LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

7328 Issued in AK

Legal business name

JESSE ATWOOD MD PEDIATRICS, LLC

Doing business as

Jesse Atwood MD Pediatrics

Practice address

2500 S Woodworth Loop
Palmer, AK 99645-8984

Phone

(907) 861-6000

NPI assigned

Aug 6, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Jesse William Atwood, M.D.NPI 1700894664

Title

President

Phone

(509) 999-0949

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jesse Atwood MD Pediatrics Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jesse W Atwood, MD

  • Pediatrics Physician
  • Palmer, AK
  • NPI 1700894664
  NPD Authorized official

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

{
    "created_epoch": "1438819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680134400000",
    "number": "1669858106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 876166",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996876166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 S WOODWORTH LOOP",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996458984",
            "telephone_number": "907-861-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 Tongass Ave",
            "address_purpose": "LOCATION",
            "city": "Ketchikan",
            "state": "AK",
            "postal_code": "999015746",
            "country_code": "US",
            "telephone_number": "907-225-5171",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "216 14th Ave SW",
            "address_purpose": "LOCATION",
            "city": "Sidney",
            "state": "MT",
            "postal_code": "592703519",
            "country_code": "US",
            "telephone_number": "406-488-2100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JESSE ATWOOD MD PEDIATRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-06",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A",
        "authorized_official_last_name": "ATWOOD",
        "authorized_official_first_name": "JESSE",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "509-999-0949",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "AK",
            "license": "7328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD4770",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jesse Atwood MD Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jesse Atwood MD Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Samantha I Ivey
• Eden Catherine Arzella Jacobs
• Rick R Jahn Jr., D.O.M.
• Kristine M Jakiemiec, PAC
• Samantha Jamison
• Russell A Johanson, M.D.
• Erin Michelle John
• Michael William Johndro, LMFT
• Hannah Christine Johnson
• Jaclyn H Johnson

• Pediatrics Physician in Palmer, AK
• Providers in Palmer, AK by specialty
• Pediatrics Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.