NPIMap

Organization Active NPI

Stanley Health Clinics PC

Doing business as Back and Neck Pain Relief Center of Wasilla

  • Chiropractor
  • Wasilla, AK
National Provider Identifier
1891828786
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0295 Issued in AK
Legal business name
STANLEY HEALTH CLINICS PC
Doing business as
Back and Neck Pain Relief Center of Wasilla
Practice address
300 W Swanson Ave
Suite 109
Wasilla, AK 99654-6827
Phone
(907) 376-2600
Fax
(907) 376-2605
NPI assigned
Mar 13, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Tyan Payne, DCNPI 1992875777
Title
Chiropractor
Phone
(907) 376-2600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X CH0295 AK Primary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X CH02971 AK

Addresses

Primary practice location

300 W Swanson Ave
Suite 109
Wasilla, AK 99654-6827

Mailing address

300 W Swanson Ave
Suite 109
Wasilla, AK 99654-6827
Phone (907) 376-2600

Other names 1

  • Back and Neck Pain Relief Center of Wasilla Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040318000413 AK Part B Supplier - Clinic/Group Practice 5294625703 Receives reassigned benefits from 2 practitioners
Practice locations: Wasilla, AK

National Provider Directory

National Provider Directory

Locations

300 W Swanson Ave
Ste 109
Wasilla, AK 99654
Phone (907) 260-7729

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891828786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W SWANSON AVE",
            "address_2": "SUITE 109",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996546827",
            "telephone_number": "907-376-2600",
            "fax_number": "907-376-2605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W SWANSON AVE",
            "address_2": "SUITE 109",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996546827",
            "telephone_number": "907-376-2600",
            "fax_number": "907-376-2605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STANLEY HEALTH CLINICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "TYAN",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "907-376-2600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "AK",
            "license": "CH0295",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "AK",
            "license": "CH02971",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Back and Neck Pain Relief Center of Wasilla",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.