Magnolia Moananu

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Practice address

3722 Parsons Ave
Anchorage, AK 99508-1216

Phone

(907) 201-9857

NPI assigned

Nov 1, 2023

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1698796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1750154779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3722 PARSONS AVE",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995081216",
            "telephone_number": "907-201-9857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3722 PARSONS AVE",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995081216",
            "telephone_number": "907-201-9857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOANANU",
        "first_name": "MAGNOLIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-01",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Marie Mixon, LPC
• Ryan Scott Mizelle
• Peter O Mjos, MD
• MM LLC
• Amelia Moananu
• Michel Moandal
• Desiree Leeann Mobeck
• Joyce Ilene Mobley
• Michael Mobley
• Shauna Nicole Mobley, LMT

• Mental Illness Community Based Residential Treatment Facility in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Mental Illness Community Based Residential Treatment Facility in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.