Individual provider Active NPI

Haiden Reeder Grey, RN, MSN, CPNP

  • Pediatric Nurse Practitioner
  • Anchorage, AK
National Provider Identifier
1902131600
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
0024165892 Issued in VA
Practice address
2925 Debarr Rd Ste 230
Anchorage, AK 99508-2959
Phone
(907) 777-1800
Fax
(907) 278-2066
NPI assigned
Oct 14, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 0024165892 VA Primary

Addresses

Primary practice location

2925 Debarr Rd Ste 230
Anchorage, AK 99508-2959

Mailing address

2925 Debarr Rd Ste 230
Anchorage, AK 99508-2959
Phone (907) 777-1800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Pediatric Nurse Practitioner, Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
0024165892VAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alaska Center for Pediatrics, LLC PastSince Nov 12, 2023 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9493/brand/2/csg/1/fhir/r4
  • Direct secure messaging: haiden.grey.1@9493.direct.athenahealth.com

Organizations & group practices 1

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": "1255478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1902131600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 DEBARR RD STE 230",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082959",
            "telephone_number": "907-777-1800",
            "fax_number": "907-278-2066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 DEBARR RD STE 230",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082959",
            "telephone_number": "907-777-1800",
            "fax_number": "907-278-2066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREY",
        "first_name": "HAIDEN",
        "middle_name": "REEDER",
        "credential": "RN, MSN, CPNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-14",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024165892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.