Individual provider Active NPI

Debra L Cyphert, MSN, FNP-BC

  • Family Nurse Practitioner
  • Bethel, AK
National Provider Identifier
1982601498
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R31359 Issued in NM
Practice address
PO Box 1908
Bethel, AK 99559-1908
Phone
(907) 543-3773
Fax
(907) 543-3545
NPI assigned
Jun 30, 2005
Last updated
Aug 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 114012 AK
Family Nurse Practitioner 363LF0000X R31359 NM Primary

Addresses

Primary practice location

PO Box 1908
Bethel, AK 99559-1908

Mailing address

PO Box 1908
Bethel, AK 99559-1908
Phone (907) 543-3773

Other identifiers 2

IdentifierTypeStateIssuer
79785557MedicaidNM
164951MedicaidAK

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161026000600 AK Practitioner - Nurse Practitioner 9739141946 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
114012AKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bethel Family Clinic CurrentSince May 7, 2022 Accepting new patients
Kodiak Island Health Care Foundation CurrentSince Aug 8, 2016 Accepting new patients
Kodiak Island Health Care Foundation CurrentSince Jan 28, 2024 Accepting new patients
Bethel Family Clinic CurrentSince May 7, 2022 Accepting new patients
Denali Asthma and Pulmonary, LLC Past Accepting new patients

Locations

1911 E Rezanof Dr
Kodiak, AK 99615
Phone (907) 481-2484

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1982601498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1908",
            "city": "BETHEL",
            "state": "AK",
            "postal_code": "995591908",
            "telephone_number": "907-543-3773",
            "fax_number": "907-543-3545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 1908",
            "city": "BETHEL",
            "state": "AK",
            "postal_code": "995591908",
            "telephone_number": "907-543-3773",
            "fax_number": "907-543-3545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CYPHERT",
        "first_name": "DEBRA",
        "middle_name": "L",
        "credential": "MSN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-30",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "114012",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "R31359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "79785557",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164951",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethel, AK

Sources for this page

Verify at the official NPI Registry.