Misty Glen Assisted Living LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

MISTY GLEN ASSISTED LIVING LLC

Practice address

2120 Misty Glen Cir
Anchorage, AK 99502-4643

Phone

(907) 306-4173

NPI assigned

Oct 21, 2021

Last updated

Oct 21, 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

Jessica FultonNPI 1629585229

Title

Owner

Phone

(907) 306-4173

Specialties & licenses 1

Addresses

Electronic endpoints 1

Practitioners 1

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.

• Jessica Tiara Fulton

  • Assisted Living Facility (Mental Illness)
  • Anchorage, AK
  • NPI 1629585229
  NPD Authorized official

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

{
    "created_epoch": "1634774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634774400000",
    "number": "1699438010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W 76TH AVE APT 105",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995182551",
            "telephone_number": "907-306-4173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 MISTY GLEN CIR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995024643",
            "telephone_number": "907-306-4173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISTY GLEN ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-21",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A",
        "authorized_official_last_name": "FULTON",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-306-4173"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@oal.directak.net",
            "affiliation": "N",
            "endpointDescription": "DSM Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2120 Misty Glen Cir",
            "city": "Anchorage",
            "state": "AK",
            "country_code": "US",
            "postal_code": "995024643",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Uk'Piqk Mishibizhii
• Benjamin K Mishler, D.D.S.
• Irene Misi
• Zackary Misner
• Karen A Missire
• Mitchell Chiropractic, Inc.
• Carol Mitchell Springer, MD
• Alex Maurice Mitchell
• Chelsea M Mitchell
• Connie Mitchell

• Home Health Agency in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Home Health Agency in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; 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.