Amy Elizabeth Vagedes

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

34.012353 Issued in OH

Practice address

2630 Central Ave
Eielson AFB, AK 99702-2301

Phone

(907) 377-6455

NPI assigned

Mar 31, 2014

Last updated

Apr 18, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amy.vagedes@direct.tananavalley.nextgenshare.com

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.

• Tanana Valley Clinic LLC

  • Multi-Specialty Clinic/Center
  • Fairbanks, AK
  • NPI 1922559558
  Medicare reassignment NPD
• Tanana Valley Clinic LLC

  • Multi-Specialty Clinic/Center
  • Fairbanks, AK
  • NPI 1073081485
  NPD

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

{
    "created_epoch": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555545600000",
    "number": "1699193318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1195 HASELTON RD.",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44121",
            "telephone_number": "330-575-7110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 CENTRAL AVE",
            "city": "EIELSON AFB",
            "state": "AK",
            "postal_code": "997022301",
            "telephone_number": "907-377-6455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3415 Laurance Rd Unit A",
            "address_purpose": "LOCATION",
            "city": "North Pole",
            "state": "AK",
            "postal_code": "997056716",
            "country_code": "US",
            "telephone_number": "330-575-7110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAGEDES",
        "first_name": "AMY",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-31",
        "last_updated": "2019-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "34.012353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miles A. Stutes, DPT
• Caitlin Renee Treloar, LCSW
• Drayden Turman, MED, ATC
• Thomas Michael Urbany, IDMT
• Anthony-Edward K Urbi, ATC
• Genesis Y Velasquez
• Jeremy Mantle Wells, D.D.S.
• Brandy Willett, PHARMD
• Katherine Patterson Willett, PA-C
• Ulyana Aleksandrovna Zagurskaya, DO

• Pediatrics Physician in Eielson AFB, AK
• Providers in Eielson AFB, AK by specialty
• Pediatrics Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.