Active NPI
Alaska Open Imaging Center LLC
- Diagnostic Radiology Physician
- Wasilla, AK
National Provider Identifier
1811063571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 704593
- Legal business name
- ALASKA OPEN IMAGING CENTER LLC
- Practice address
- 1751 Gardner Way Ste B
Wasilla, AK 99654-6564 - Phone
- (907) 357-1220
- Fax
- (907) 357-1222
- NPI assigned
- Nov 27, 2006
- 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
- Mr. Jeff Kinion
- Title
- Ceo
- Phone
- (907) 357-1220
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 704593 | AK | Primary |
Addresses
Primary practice location
1751 Gardner Way Ste B
Wasilla, AK 99654-6564
Mailing address
1751 Gardner Way Ste B
Wasilla, AK 99654-6564
Phone (907) 357-1220
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MDG1553 | Medicaid | AK | |
| MDG1551 | Medicaid | AK | |
| MDG155 | Medicaid | AK | |
| MDG1552 | Medicaid | AK | |
| N2018 | Other | AK | BC BS AOIC NUMBER |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164585600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1191542400000",
"number": "1811063571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1751 GARDNER WAY STE B",
"city": "WASILLA",
"state": "AK",
"postal_code": "996546564",
"telephone_number": "907-357-1220",
"fax_number": "907-357-1222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1751 GARDNER WAY STE B",
"city": "WASILLA",
"state": "AK",
"postal_code": "996546564",
"telephone_number": "907-357-1220",
"fax_number": "907-357-1222"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ALASKA OPEN IMAGING CENTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-27",
"last_updated": "2007-10-05",
"status": "A",
"authorized_official_last_name": "KINION",
"authorized_official_first_name": "JEFF",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "907-357-1220",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": "AK",
"license": "704593",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MDG1553",
"state": "AK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MDG1551",
"state": "AK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MDG155",
"state": "AK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MDG1552",
"state": "AK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC BS AOIC NUMBER",
"identifier": "N2018",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}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 Oct 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.