NPIMap

Organization Active NPI

Altair Integrative Wellness

  • Sports Physician Chiropractor
  • Wasilla, AK
National Provider Identifier
1932744836
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
Legal business name
ALTAIR INTEGRATIVE WELLNESS
Practice address
892 E USA Cir Ste 108
Wasilla, AK 99654-7106
Phone
(907) 357-1818
Fax
(907) 357-1814
NPI assigned
Nov 14, 2019
Last updated
Nov 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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

Authorized official

Name
Dr. Tara E Workman DC, DC
Title
Ceo
Phone
(907) 357-1818

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X
Family Nurse Practitioner 363LF0000X
Sports Physician Chiropractor 111NS0005X Primary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X

Addresses

Primary practice location

892 E USA Cir Ste 108
Wasilla, AK 99654-7106

Mailing address

892 E USA Cir Ste 108
Wasilla, AK 99654-7106
Phone (907) 357-1818

Other identifiers 3

IdentifierTypeStateIssuer
1702799MedicaidAK
1636141MedicaidAK
1633093MedicaidAK

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL Tebra Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191219001806 AK Part B Supplier - Clinic/Group Practice 9133553464 Receives reassigned benefits from 6 practitioners
Practice locations: Wasilla, AK

National Provider Directory

National Provider Directory

Locations

3161 E Palmer Wasilla Hwy
Ste 1C
Wasilla, AK 99654
Phone (907) 357-1818

892 E USA Cir
Ste 108
Wasilla, AK 99654
Phone (907) 357-1818

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1573689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732492800000",
    "number": "1932744836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "892 E USA CIR STE 108",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547106",
            "telephone_number": "907-357-1818",
            "fax_number": "907-357-1814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "892 E USA CIR STE 108",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547106",
            "telephone_number": "907-357-1818",
            "fax_number": "907-357-1814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTAIR INTEGRATIVE WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-14",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A",
        "authorized_official_last_name": "WORKMAN DC",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "907-357-1818",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1702799",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1636141",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1633093",
            "state": "AK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Tebra",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "892 E USA Cir Ste 108",
            "city": "Wasilla",
            "state": "AK",
            "country_code": "US",
            "postal_code": "996547106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.