NPIMap

Organization Active NPI

Anodyne Pain & Wellness of Anchorage LLC

  • Physical Medicine & Rehabilitation Physician
  • Anchorage, AK
National Provider Identifier
1790323632
Registry record updated Feb 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
ANODYNE PAIN & WELLNESS OF ANCHORAGE LLC
Practice address
500 E Benson Blvd Ste 103
Anchorage, AK 99503-4148
Phone
(907) 561-4474
NPI assigned
Dec 11, 2019
Last updated
Feb 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2021

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

Authorized official

Name
Judd WattenbargerNPI 1336153568
Title
Owner
Phone
(303) 995-1622

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X
Chiropractor 111N00000X
Physical Medicine & Rehabilitation Physician 208100000X Primary
Pain Medicine Physician 208VP0000X
Physical Therapist 225100000X
Massage Therapist 225700000X

Addresses

Primary practice location

500 E Benson Blvd Ste 103
Anchorage, AK 99503-4148

Mailing address

500 E Benson Blvd Ste 103
Anchorage, AK 99503-4148
Phone (907) 561-4474

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1576022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613952000000",
    "number": "1790323632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 E BENSON BLVD STE 103",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995034148",
            "telephone_number": "907-561-4474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E BENSON BLVD STE 103",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995034148",
            "telephone_number": "907-561-4474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANODYNE PAIN & WELLNESS OF ANCHORAGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-11",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A",
        "authorized_official_last_name": "WATTENBARGER",
        "authorized_official_first_name": "JUDD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-995-1622"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Feb 22, 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.