Individual provider Active NPI

Marianne Johnstone-Petty, MSN, FNP-C

  • Family Nurse Practitioner
  • Anchorage, AK
National Provider Identifier
1871896894
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1189 Issued in AK
Practice address
3200 Providence Dr
Suite B111
Anchorage, AK 99508-4615
Phone
(907) 212-7997
Fax
(907) 212-8225
NPI assigned
Dec 13, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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 1189 AK Primary

Addresses

Primary practice location

3200 Providence Dr
Suite B111
Anchorage, AK 99508-4615

Mailing address

PO Box 4105
Portland, OR 97208-4105
Phone (866) 907-1068

Other practice location 1

1200 Hilyard St Ste 230
Eugene, OR 97401-8122
Phone (458) 205-7450

Other identifiers 2

IdentifierTypeStateIssuer
1730113739OtherAKPATIENTS FIRST MEDICAL CLINIC LLC - TYPE 2
1571407MedicaidAK

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mjohnstonepetty316620@ak.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, OR2 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
I20110314001040 AK Practitioner - Nurse Practitioner 2567644453 Reassigns benefits to 1 organization
I20250626001439 OR Practitioner - Nurse Practitioner 2567644453 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peacehealth Medical GroupGroup PAC ID 9032023270, 256 clinicians

Practice addresses (Care Compare)

1200 Hilyard St
Eugene, OR 97401-8122
Phone (458) 205-6011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Maria L Freeman CurrentSince May 31, 2020 Accepting new patients
Peacehealth Medical Group CurrentSince Aug 10, 2025 Accepting new patients
Providence Health & Services- Washington CurrentSince Dec 7, 2015 Accepting new patients
Family Medicine of Alaska Inc CurrentSince Mar 14, 2011 Accepting new patients

Locations

3200 Providence Dr
Anchorage, AK 99508
Phone (907) 261-3111

6307 Debarr Rd
Ste C
Anchorage, AK 99504
Phone (907) 212-3420

3200 Providence Dr
Ste B111
Anchorage, AK 99508
Phone (907) 212-7890

920 Compassion Cir
Anchorage, AK 99504
Phone (907) 212-9200

1261 S Seward Meridian Pkwy
Ste A
Wasilla, AK 99654
Phone (907) 376-1276

1200 Hilyard St
Eugene, OR 97401
Phone (458) 205-7070

4010 Aerial Way
Eugene, OR 97402
Phone (541) 242-8300

1200 Hilyard St
Ste 230
Eugene, OR 97401
Phone (458) 205-6016

Interoperability endpoints

  • Direct secure messaging: mjohnstonepetty768775@direct.peacehealth.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/GGIIDD/Endpoint/GGIIDD

Organizations & group practices 4

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": "1292198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1871896894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4105",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084105",
            "telephone_number": "866-907-1068",
            "fax_number": "425-917-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 PROVIDENCE DR",
            "address_2": "SUITE B111",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084615",
            "telephone_number": "907-212-7997",
            "fax_number": "907-212-8225"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Hilyard St Ste 230",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974018122",
            "country_code": "US",
            "telephone_number": "458-205-7450",
            "fax_number": "458-205-7459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSTONE-PETTY",
        "first_name": "MARIANNE",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-13",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "1189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PATIENTS FIRST MEDICAL CLINIC LLC - TYPE 2",
            "identifier": "1730113739",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1571407",
            "state": "AK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mjohnstonepetty316620@ak.providencedirect.org",
            "affiliation": "N",
            "address_1": "3200 Providence Dr",
            "address_2": "Suite B111",
            "city": "Anchorage",
            "state": "AK",
            "country_code": "US",
            "postal_code": "995084615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.