Active NPI
Lynx Medical Services Organization
- Family Medicine Physician
- Wasilla, AK
National Provider Identifier
1790044592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- LYNX MEDICAL SERVICES ORGANIZATION
- Practice address
- 3066 E Meridian Park Loop
Wasilla, AK 99654-7299 - Phone
- (907) 357-9590
- Fax
- (907) 357-9593
- NPI assigned
- May 14, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Daniel J Crane
- Title
- Chief Operating Officer
- Phone
- (800) 909-5866
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
3066 E Meridian Park Loop
Wasilla, AK 99654-7299
Mailing address
777 E 2100 S
Salt Lake City, UT 84106-1829
Phone (800) 909-5866
Other names 1
- Capstone Family Medicine
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AK
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120626000747 | AK | Part B Supplier - Clinic/Group Practice | 3971768854 |
Receives reassigned benefits from 3 practitioners 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Wasilla, AK; Juneau, AK; Anchorage, AK |
Other NPIs on the same Medicare enrollment 2
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Pain Medicine Physician
- Salt Lake City, UT
- NPI 1891054771
O20120626000747
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1336953600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1336953600000",
"number": "1790044592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "777 E 2100 S",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841061829",
"telephone_number": "800-909-5866",
"fax_number": "801-665-1882"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3066 E MERIDIAN PARK LOOP",
"city": "WASILLA",
"state": "AK",
"postal_code": "996547299",
"telephone_number": "907-357-9590",
"fax_number": "907-357-9593"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LYNX MEDICAL SERVICES ORGANIZATION",
"organizational_subpart": "NO",
"enumeration_date": "2012-05-14",
"last_updated": "2012-05-14",
"status": "A",
"authorized_official_last_name": "CRANE",
"authorized_official_first_name": "DANIEL",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
"authorized_official_telephone_number": "800-909-5866"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Capstone Family Medicine",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Wasilla, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.