Katherine Grace Van Atta, PA-C, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

Practice address

5000 E Shennum Dr
Wasilla, AK 99654-7718

Phone

(907) 373-3420

Fax

(907) 376-7847

NPI assigned

Dec 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AK, TX3 enrollments

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 3

Specialty

Certified Nurse Midwife (CNM)

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Camai Community Health Center Inc 12 clinicians

Mat-Su Midwifery Inc 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: katherine.van.atta.1@20726.direct.athenahealth.com

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.

• Mat-Su Midwifery Inc

  • Midwife
  • Wasilla, AK
  • NPI 1275696486

  AK

  Medicare reassignment Care Compare group NPD
• Camai Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Naknek, AK
  • NPI 1679718019

  AK

  Medicare reassignment Care Compare group
• Alaska Native Tribal Health Consortium

  • General Acute Care Hospital
  • Anchorage, AK
  • NPI 1437189339

  TX

  Medicare reassignment NPD
• Medical Network of Alaska, LLC

  • Urgent Care Clinic/Center
  • Wasilla, AK
  • NPI 1538414834

  AK

  Medicare reassignment NPD
• Obhg Alaska, P.C.

  • Obstetrics & Gynecology Physician
  • Anchorage, AK
  • NPI 1740697069

  AK

  Medicare reassignment NPD
• Eastern Aleutian Tribes, Inc

  • Community Health Clinic/Center
  • Adak, AK
  • NPI 1285796094

  AK

  Medicare reassignment
• Eastern Aleutian Tribes, Inc.

  • Community Health Clinic/Center
  • Nelson Lagoon, AK
  • NPI 1003970062
  NPD
• Medical Network of Alaska, LLC

  • Clinical Medical Laboratory
  • Wasilla, AK
  • NPI 1467167585
  NPD
• Medical Network of Alaska, LLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Wasilla, AK
  • NPI 1831763911
  NPD
• Medical Network of Alaska, LLC

  • Otolaryngology Physician
  • Anchorage, AK
  • NPI 1922862986
  NPD
• Alaska Imaging Associates, LLC

  • Diagnostic Radiology Physician
  • Anchorage, AK
  • NPI 1063466688
  NPD (past)
• Bristol Bay Borough

  • Federally Qualified Health Center (FQHC)
  • Naknek, AK
  • NPI 1629105804
  NPD (past)

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1740358167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 E SHENNUM DR",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547718",
            "telephone_number": "907-373-3420",
            "fax_number": "907-376-7847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 E SHENNUM DR",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547718",
            "telephone_number": "907-373-3420",
            "fax_number": "907-376-7847"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3505 E Meridian Park Loop Ste 100",
            "address_purpose": "LOCATION",
            "city": "Wasilla",
            "state": "AK",
            "postal_code": "996547242",
            "country_code": "US",
            "telephone_number": "907-357-4963",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2650 E Broadview Ave",
            "address_purpose": "LOCATION",
            "city": "Wasilla",
            "state": "AK",
            "postal_code": "996548302",
            "country_code": "US",
            "telephone_number": "907-373-3420",
            "fax_number": "907-376-7847",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 School Road",
            "address_purpose": "LOCATION",
            "city": "Naknek",
            "state": "AK",
            "postal_code": "99633",
            "country_code": "US",
            "telephone_number": "907-246-6155",
            "fax_number": "907-246-6158",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3380 C St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995033949",
            "country_code": "US",
            "telephone_number": "907-277-1440",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4320 Diplomacy Dr Ste 2602",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995085925",
            "country_code": "US",
            "telephone_number": "907-729-4245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN ATTA",
        "first_name": "KATHERINE",
        "middle_name": "GRACE",
        "name_prefix": "Ms.",
        "credential": "PA-C, CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "879",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MDA0205",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valley Skill Center, Inc.
• Valley Upright Imaging LLC
• Valley Vitality Wellness LLC
• Lorraine Linda Valli
• Valor Midwifery Services
• Charles Hurst Van Ravenswaay
• Jessica D Van Wulven, PA-C
• Macy Vanbuskirk
• Tristan Shea Vandelac
• Susan Vander Martin, RN

• All providers in Wasilla, AK
• Advanced Practice Midwife in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; 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.
• 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.