Pivotal Care Partnership LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

PIVOTAL CARE PARTNERSHIP LLC

Practice address

2925 Debarr Rd Ste 199
Anchorage, AK 99508-2959

Phone

(907) 632-5057

NPI assigned

Oct 19, 2020

Last updated

Dec 30, 2020By 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

Bruce Havelock

Title

Director

Phone

(907) 375-2025

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22716/brand/1/csg/1/fhir/r4

Practitioners 2

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.

• Je'Dette Angelique Green, ANP-C

  • Family Nurse Practitioner
  • Anchorage, AK
  • NPI 1588968945
  Medicare reassignment Care Compare group NPD
• Adrienne Jane Johnson, ANP,FNP-BC,APRN, MSN

  • Family Nurse Practitioner
  • Anchorage, AK
  • NPI 1235575788
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1603065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609286400000",
    "number": "1811596026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 90812",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995090812",
            "telephone_number": "907-375-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 DEBARR RD STE 199",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082959",
            "telephone_number": "907-632-5057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIVOTAL CARE PARTNERSHIP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-19",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A",
        "authorized_official_last_name": "HAVELOCK",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "907-375-2025"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1588968945",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sigrid Piszczek
• Theresa Pitcher
• Katrina L Pitre, COTA
• Kimberly Sue Pitts, RRT-NPS, RPSGT
• Lindsey N Pitts, CDC II
• James J. Pizzadili, D.C.
• PK RX LLC (Reliance Medsets)
• Planned Parenthood of Alaska
• Planned Parenthood of Alaska
• Planned Parenthood of Alaska

• Clinic/Center in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Clinic/Center in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2020; 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.

Verify at the official NPI Registry.