Juneau Spine and Pain Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

360285 Issued in AK

Legal business name

JUNEAU SPINE AND PAIN CENTER LLC

Doing business as

Southeast Alaska Surgery Center

Practice address

3200 Hospital Dr
Suite 100
Juneau, AK 99801-7808

Phone

(907) 523-5962

Fax

(800) 766-1962

NPI assigned

Dec 9, 2009

Last updated

Mar 23, 2016By 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

John Bursell, MD

Title

Member

Phone

(907) 723-9885

Specialties & licenses 1

Addresses

Other names 1

• Southeast Alaska Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

Listed as

Southeast Alaska Surgery CenterCCN 02C0001010

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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.

• Lisa Brendle, RN

  • Registered Nurse
  • Sitka, AK
  • NPI 1033352273
  NPD (past)
• Marco Nee Wen, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Kirkland, WA
  • NPI 1942245733
  NPD (past)

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

{
    "created_epoch": "1260316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458691200000",
    "number": "1821327560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 HOSPITAL DR",
            "address_2": "SUITE 100",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998017808",
            "telephone_number": "907-523-5962",
            "fax_number": "800-766-1962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 HOSPITAL DR",
            "address_2": "SUITE 100",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998017808",
            "telephone_number": "907-523-5962",
            "fax_number": "800-766-1962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUNEAU SPINE AND PAIN CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-09",
        "last_updated": "2016-03-23",
        "status": "A",
        "authorized_official_last_name": "BURSELL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "907-723-9885",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AK",
            "license": "360285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeast Alaska Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Juneau Pharmacy Inc (Juneau Drug Company)
• Juneau Physical Therapy
• Juneau Quick Care
• Juneau School District
• Juneau Sleep Diagnostics Center LLC
• Juneau Ultrasound, LLC
• Juneau Women's Health LLC
• Olivia Claire Kack
• Miraha Kalbaugh
• Emily Alice Kane, ND

• Ambulatory Surgical Clinic/Center in Juneau, AK
• Providers in Juneau, AK by specialty
• Ambulatory Surgical Clinic/Center in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.