Zan Michael Whitman, ARNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

102761 Issued in AK

Practice address

12812 Old Glenn Hwy Ste C4
Eagle River, AK 99577-7002

Phone

(907) 726-0378

Fax

(907) 726-0374

NPI assigned

Apr 12, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AK, WA2 enrollments

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.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Health and Services WashingtonGroup PAC ID 6709782600, 480 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: zwhitman534568@wm.providencedirect.org

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.

• Providence Health & Services Washington

  dba Providence Medical Group SouthWest Washington

  • Family Medicine Physician
  • Olympia, WA
  • NPI 1174744304
  Medicare reassignment Care Compare group NPD
• Eagle River Behavioral Health, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Eagle River, AK
  • NPI 1366062903
  Authorized official Same address or phone
• Eagle River Behavioral Health

  • Psychiatry Physician
  • Eagle River, AK
  • NPI 1073307328
  NPD
• Providence Health & Services- Washington

  dba Providence Medical Group Alaska

  • Critical Care Medicine (Internal Medicine) Physician
  • Anchorage, AK
  • NPI 1093956278
  NPD (past)

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

{
    "created_epoch": "1428796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1902292386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 770870",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995770870",
            "telephone_number": "907-726-0378",
            "fax_number": "907-726-0374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12812 OLD GLENN HWY STE C4",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777002",
            "telephone_number": "907-726-0378",
            "fax_number": "907-726-0374"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10928 Eagle River Rd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Eagle River",
            "state": "AK",
            "postal_code": "995778078",
            "country_code": "US",
            "telephone_number": "907-726-0378",
            "fax_number": "907-726-0374",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITMAN",
        "first_name": "ZAN",
        "middle_name": "MICHAEL",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-12",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AK",
            "license": "102761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Wellik, M.S., CCC-SLP
• Jacqueline Homm Wells, DMD
• Katrina White, L.AC.
• Rachel Lynn White, PHD, BCBA-D, LBA
• Amy Kathryn Whitley, LCSW
• Wholistic Counseling
• Brooklyn Racquel Sharon Wicks
• Angela Wilbanks, PMHNP-BC
• Misty Wilcox
• William R. Evans, DDS, Apc

• Psychiatric/Mental Health Nurse Practitioner in Eagle River, AK
• Providers in Eagle River, AK by specialty
• Psychiatric/Mental Health Nurse Practitioner in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2023; 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.

Verify at the official NPI Registry.