Individual provider Active NPI

Andrea Leigh Payne, NP-C

  • Family Nurse Practitioner
  • Skagway, AK
National Provider Identifier
1831525245
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
154629 Issued in AK
Practice address
1.7 Dyea Road
Skagway, AK 99840
Phone
(423) 488-2345
NPI assigned
Sep 17, 2013
Last updated
Aug 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 154629 AK Primary

Addresses

Primary practice location

1.7 Dyea Road
Skagway, AK 99840

Mailing address

PO Box 1352
Skagway, AK 99840-1352
Phone (423) 488-2345

Other identifiers 1

IdentifierTypeStateIssuer
Q025271MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200207001968 AK Practitioner - Nurse Practitioner 0840420410 Reassigns benefits to 1 organization
I20230316000840 TX Practitioner - Nurse Practitioner 0840420410 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
154629AKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Soldotna Family Practice LLC CurrentSince Nov 7, 2024 Accepting new patients
Metlakatla Indian Community CurrentSince Feb 13, 2023 Accepting new patients
Dennis Clifford Ford MD Past Accepting new patients
Diagnostic Radiology Consultants PA PastSince Feb 1, 2018 Accepting new patients
Paul E. Pinson Dba/Pain and Spine Specialists Past Accepting new patients
Scenic City Rheumatology, PLLC Past Accepting new patients

Locations

44604 Sterling Hwy
Ste D
Soldotna, AK 99669
Phone (907) 420-0476

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1379376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1831525245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1352",
            "city": "SKAGWAY",
            "state": "AK",
            "postal_code": "998401352",
            "telephone_number": "423-488-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1.7 DYEA ROAD",
            "city": "SKAGWAY",
            "state": "AK",
            "postal_code": "99840",
            "telephone_number": "423-488-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "ANDREA",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-17",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "154629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q025271",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Skagway, AK

Sources for this page

Verify at the official NPI Registry.