Individual provider Active NPI

Jean L Rounds-Riley, PA-C

  • Physician Assistant
  • Anchorage, AK
National Provider Identifier
1750569901
Registry record updated Sep 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
254 Issued in AK
Practice address
4000 Ambassador Dr
Anchorage, AK 99508-5909
Phone
(907) 563-2662
NPI assigned
Feb 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 254 AK Primary

Addresses

Primary practice location

4000 Ambassador Dr
Anchorage, AK 99508-5909

Mailing address

4000 Ambassador Dr
Anchorage, AK 99508-5909
Phone (907) 563-2662

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
254AKMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1202428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222214400000",
    "number": "1750569901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 AMBASSADOR DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085909",
            "telephone_number": "907-563-2662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 AMBASSADOR DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085909",
            "telephone_number": "907-563-2662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUNDS-RILEY",
        "first_name": "JEAN",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-08",
        "last_updated": "2008-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2008; 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.