Heritage Family Medicine LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

6506 Issued in AK

Legal business name

HERITAGE FAMILY MEDICINE LLC

Practice address

4961 E Mayflower LN
Wasilla, AK 99654-7708

Phone

(907) 376-5337

NPI assigned

Dec 17, 2009

Last updated

Mar 15, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Christopher Sahlstrom, MDNPI 1104858604

Title

Owner

Phone

(907) 982-5300

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Christopher James Sahlstrom, MD

  • Family Medicine Physician
  • Wasilla, AK
  • NPI 1104858604
  Medicare reassignment Care Compare group NPD Authorized official
• Craig Michael Brumagin

  • Medical Physician Assistant
  • Wasilla, AK
  • NPI 1912549098
  Medicare reassignment Care Compare group
• Jann Lee Urban, M.D.

  • Anesthesiology Physician
  • Anchorage, AK
  • NPI 1487643169
  NPD (past)

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

{
    "created_epoch": "1261008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615766400000",
    "number": "1699004853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4931 E MAYFLOWER LN",
            "address_2": "SUITE 1",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547759",
            "telephone_number": "907-376-5337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4961 E MAYFLOWER LN",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547708",
            "telephone_number": "907-376-5337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE FAMILY MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-17",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A",
        "authorized_official_last_name": "SAHLSTROM",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-982-5300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "6506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD0506",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MPG0164",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Hennessey, DPT
• Angela Rene Henry
• Donald Kenton Henry, BSW SOCIAL WORKER
• William Henslee
• Alicia Henson
• Heritage Medical Group LLC
• Kristal M Hermon
• Adriana Maria Hernandez, CNM, PMHNP-BC
• Mikaela Maree Hernandez, NP
• Jessica Herndon, MSW

• Family Medicine Physician in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Family Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.