Family Diabetes Clinic

Primary specialty

Family Health Clinical Nurse SpecialistTaxonomy code 364SF0001X

License

688 Issued in AK

Legal business name

FAMILY DIABETES CLINIC

Practice address

1407 W 31St Ave
Ste. 600
Anchorage, AK 99503-3678

Phone

(907) 677-3750

Fax

(907) 677-3751

NPI assigned

Jul 28, 2011

Last updated

Nov 18, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tracy L Michalski, ANP

Title

Owner

Phone

(907) 677-3750

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1311811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321574400000",
    "number": "1801174586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 W 31ST AVE",
            "address_2": "STE. 200",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995033678",
            "telephone_number": "907-677-3750",
            "fax_number": "907-677-3751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 W 31ST AVE",
            "address_2": "STE. 600",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995033678",
            "telephone_number": "907-677-3750",
            "fax_number": "907-677-3751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DIABETES CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-28",
        "last_updated": "2011-11-18",
        "status": "A",
        "authorized_official_last_name": "MICHALSKI",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-677-3750",
        "authorized_official_credential": "ANP"
    },
    "taxonomies": [
        {
            "code": "364SF0001X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "AK",
            "license": "688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MPG0391",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Health Clinical Nurse Specialist in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Family Health Clinical Nurse Specialist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2011; 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.