Kerry A Anson, PA-C, ATC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1073 Issued in AK

Practice address

17025 Snowmobile LN
Eagle River, AK 99577-7044

Phone

(907) 694-9553

Fax

(907) 694-9585

NPI assigned

Nov 9, 2012

Last updated

Sep 28, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kerry A Kucko Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2026 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Medical Network of Alaska, LLC

  dba MNA Laboratory

  • Clinical Medical Laboratory
  • Wasilla, AK
  • NPI 1467167585
  NPD
• Functional Medicine of Idaho PC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1336656040
  NPD (past)

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

{
    "created_epoch": "1352419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506556800000",
    "number": "1902150139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3066 E MERIDIAN PARK LOOP",
            "address_2": "STE 3",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547254",
            "telephone_number": "907-357-9590",
            "fax_number": "907-357-9593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17025 SNOWMOBILE LN",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777044",
            "telephone_number": "907-694-9553",
            "fax_number": "907-694-9585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANSON",
        "first_name": "KERRY",
        "middle_name": "A",
        "credential": "PA-C, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-09",
        "last_updated": "2017-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AK",
            "license": "1073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KERRY",
            "last_name": "KUCKO",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Karin Anderson, LCSW
• Anesthesia Staffing Services, P.C.
• Angels Above Assisted Living LLC (Angels Above Assisted Living)
• Aylar Ansaritalesh, PA-C
• Megan Anshutz
• Aofalaska LLC (Mountain Vista ALH)
• Michelle A Appel
• Arctic Chiropractic & Physical Medicine Eagle River LLC
• Arctic Oral Surgery, LLC
• Arctic Speech Services, Inc

• Medical Physician Assistant in Eagle River, AK
• Providers in Eagle River, AK by specialty
• Medical Physician Assistant in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2017; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.