Active NPI
Jordan Stancombe, PA
- Physician Assistant
- Palmer, AK
National Provider Identifier
1902214521
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 127956
- Practice address
- 12113 E Maple Springs Way
Palmer, AK 99645-9648 - Phone
- (907) 745-4488
- Fax
- (907) 745-4487
- NPI assigned
- Jul 28, 2014
- Last updated
- Nov 6, 2024
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 127956 | AK | Primary |
Addresses
Primary practice location
12113 E Maple Springs Way
Palmer, AK 99645-9648
Mailing address
12113 E Maple Springs Way
Palmer, AK 99645-9648
Phone (907) 745-4488
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
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
12113 E Maple Springs Way
Palmer, AK 99645-9648
Phone (907) 745-4488
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1836 | NE | MD | Occupational Therapist |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Medical Specialty Clinic/Center
- Palmer, AK
- NPI 1184028573
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730851200000",
"number": "1902214521",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12113 E MAPLE SPRINGS WAY",
"city": "PALMER",
"state": "AK",
"postal_code": "996459648",
"telephone_number": "907-745-4488",
"fax_number": "907-745-4487"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12113 E MAPLE SPRINGS WAY",
"city": "PALMER",
"state": "AK",
"postal_code": "996459648",
"telephone_number": "907-745-4488",
"fax_number": "907-745-4487"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STANCOMBE",
"first_name": "JORDAN",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-28",
"last_updated": "2024-11-06",
"certification_date": "2024-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AK",
"license": "127956",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palmer, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.