Stanley Health Clinics PC
Organization Active NPI Chiropractor · Wasilla, AK
NPI 1891828786 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1891828786
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- CH0295 (AK)
- Legal business name
- STANLEY HEALTH CLINICS PC
- 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
- Organization subpart
- No
Authorized official
- Name
- Dr. Tyan Payne, DC
- Title
- Chiropractor
- Phone
- (907) 376-2600
Practitioners 19
-
Kenneth Alan Meye, D.C.
-
Denay Hardinger, LMT
-
Keyona Mattson, LMT
-
Audrey Bottomly, LMT
-
Kari Lynn Ireland, LMT
-
Taunya Palmer, LMT
-
Alexandra Rees-Benyo, LMT
-
Tatyana Russkih, LMT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040318000413 | AK | Part B Supplier - Clinic/Group Practice | 5294625703 |
Receives reassigned benefits from 2 practitioners Practice locations: Wasilla, AK |
National Provider Directory
Locations
300 W Swanson Ave
Ste 109
Wasilla, AK 99654
Phone (907) 260-7729
546 N Main St
Wasilla, AK 99654
Phone (907) 376-2600
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | CH0295 | AK | Yes |
| Chiropractor |
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 identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992875777 | Other | AK | NPI |
| 1912072000 | Other | AK | NPI |
Other names
- Back and Neck Pain Relief Center of Wasilla
Other providers in Wasilla, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.