Active NPI
Xenia S Gonzalez, FNP
- Nurse Practitioner
- Wasilla, AK
National Provider Identifier
1881633691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 874
- Practice address
- 1363 W Spruce Ave
Wasilla, AK 99654-5327 - Phone
- (907) 376-2411
- Fax
- (907) 352-3363
- NPI assigned
- Jun 6, 2006
- Last updated
- May 20, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 874 | AK | Primary |
Addresses
Primary practice location
1363 W Spruce Ave
Wasilla, AK 99654-5327
Mailing address
1363 W Spruce Ave
Wasilla, AK 99654-5327
Phone (907) 376-2411
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060627000032 | AK | Practitioner - Nurse Practitioner | 8921010471 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 874 | AK | MD | Counselor |
| 290 | AK | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Medicine of Alaska Inc | Current | Accepting new patients | |
| Maria L Freeman | Current | Accepting new patients |
Locations
1261 S Seward Meridian Pkwy
Ste A
Wasilla, AK 99654
Phone (907) 376-1276
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Wasilla, AK
- NPI 1033305875
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211241600000",
"number": "1881633691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1363 W SPRUCE AVE",
"city": "WASILLA",
"state": "AK",
"postal_code": "996545327",
"telephone_number": "907-376-2411",
"fax_number": "907-352-3363"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1363 W SPRUCE AVE",
"city": "WASILLA",
"state": "AK",
"postal_code": "996545327",
"telephone_number": "907-376-2411",
"fax_number": "907-352-3363"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "XENIA",
"middle_name": "S",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-06",
"last_updated": "2008-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "AK",
"license": "874",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wasilla, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.