Cynthia Kaye Phillips-Johnson, RN, AGNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

224414 Issued in AK

Practice address

3765 E Blue Lupine Dr Ste D
Wasilla, AK 99654-8417

Phone

(907) 707-1671

Fax

(907) 707-1675

NPI assigned

Sep 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Pioneer Peak Orthopedics LLCGroup PAC ID 8921318080, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ancora Home Health & Hospice Home health agency, Wasilla, AK, CCN 027008
• Mat-Su Regional Medical Center Hospital, Palmer, AK, CCN 020006

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Pioneer Peak Orthopedics LLC

  • Orthopaedic Surgery Physician
  • Wasilla, AK
  • NPI 1548639727
  Medicare reassignment Care Compare group NPD
• Montesano Spa Works and Massage, LLC

  • Specialist
  • Montesano, WA
  • NPI 1609082767
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ancora Home Health & Hospice, LLC

  • Home Health Agency
  • Wasilla, AK
  • NPI 1801380043
  Care Compare affiliation
• Mat-Su Valley Medical Center LLC

  • General Acute Care Hospital
  • Palmer, AK
  • NPI 1417975061
  Care Compare affiliation

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1952407090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1399 S TIM AVE",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996239338",
            "telephone_number": "385-201-4211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3765 E BLUE LUPINE DR STE D",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996548417",
            "telephone_number": "907-707-1671",
            "fax_number": "907-707-1675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS-JOHNSON",
        "first_name": "CYNTHIA",
        "middle_name": "KAYE",
        "credential": "RN, AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AK",
            "license": "141780",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00017451",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AK",
            "license": "224414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William C Petty
• Pharmacy Partners, LLC
• Pharmacy Partners, LLC
• Baylee Phelps
• Sorady Samarday Pheth
• Gina Nicole Phillips, PT, DPT
• Joseph Phillips
• Laura Phillips, RD
• Tracy Lynn Phillips, LPN
• Stephanie Piancino, LMT

• Adult Health Nurse Practitioner in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Adult Health Nurse Practitioner in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.

Verify at the official NPI Registry.