Pediatric Gastroenterology of Alaska, LLC

Primary specialty

Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X

Legal business name

PEDIATRIC GASTROENTEROLOGY OF ALASKA, LLC

Practice address

3340 Providence Dr
Suite 567
Anchorage, AK 99508-4616

Phone

(907) 276-5517

Fax

(907) 279-3655

NPI assigned

Feb 28, 2007

Organization subpart

No

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

Authorized official

Name

Charles Allan Pratt, M.D.

Title

Manager

Phone

(907) 276-5517

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192492800000",
    "number": "1962539775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 PROVIDENCE DR",
            "address_2": "SUITE 567",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084616",
            "telephone_number": "907-276-5517",
            "fax_number": "907-279-3655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 PROVIDENCE DR",
            "address_2": "SUITE 567",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084616",
            "telephone_number": "907-276-5517",
            "fax_number": "907-279-3655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC GASTROENTEROLOGY OF ALASKA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-10-16",
        "status": "A",
        "authorized_official_last_name": "PRATT",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "ALLAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "907-276-5517",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emme Lynn Adryanne Peavy
• Carly Peckham
• Inaam A Pedalino, DDS
• Veronica Rae Peddada, FNP-BC
• Pediatric Gastroenterology Inc
• Pediatric Neurology Clinic of Alaska, P.C.
• Pediatric Neuropsychological Services of Alaska, PC
• Pediatric OT Services, LLC
• Pediatric Specialists of Alaska LLC
• David J Pedigo, OD

• Pediatric Gastroenterology Physician in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Pediatric Gastroenterology Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.