Individual provider Active NPI

Jamie Ann Popham, APRN

  • Pediatric Nurse Practitioner
  • Anchorage, AK
National Provider Identifier
1841513389
Registry record updated Nov 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
143688 Issued in AK
Practice address
4315 Diplomacy Dr
Anchorage, AK 99508-5926
Phone
(907) 729-1050
NPI assigned
Mar 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 143688 AK Primary
Critical Care Pediatric Nurse Practitioner 363LP0222X 143688 AK
Registered Nurse 163W00000X 29045 AK

Addresses

Primary practice location

4315 Diplomacy Dr
Anchorage, AK 99508-5926

Mailing address

PO Box 1761
Palmer, AK 99645-1761
Phone (907) 982-9274

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20190325000743 TX Practitioner - Nurse Practitioner 2668712969 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29045AKMDRegistered Nurse
143688AKMDCritical Care Pediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southcentral Foundation CurrentSince Feb 8, 2019 Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Feb 8, 2019 Accepting new patients
Southcentral Foundation Current Accepting new patients
Southcentral Foundation Past Accepting new patients
Alaska Native Tribal Health Consortium Past Accepting new patients

Locations

7033 E Tudor Rd
Anchorage, AK 99507
Phone (907) 729-0000

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

4320 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-0000

Interoperability endpoints

  • Direct secure messaging: jpopham@direct.scf.cc

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1268265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1841513389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1761",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996451761",
            "telephone_number": "907-982-9274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4315 DIPLOMACY DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085926",
            "telephone_number": "907-729-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPHAM",
        "first_name": "JAMIE",
        "middle_name": "ANN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-11",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AK",
            "license": "143688",
            "primary": true
        },
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "AK",
            "license": "143688",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AK",
            "license": "29045",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.