Active NPI
Maria Arcilia Heritscko, LPN
- Licensed Practical Nurse
- Juneau, AK
National Provider Identifier
1982842852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 5710
- Practice address
- 5636 Glacier Hwy Ste 100
Juneau, AK 99801-9508 - Phone
- (907) 586-6838
- Fax
- (907) 586-8114
- NPI assigned
- Jan 29, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 5710 | AK | Primary |
Addresses
Primary practice location
5636 Glacier Hwy Ste 100
Juneau, AK 99801-9508
Mailing address
5636 Glacier Hwy Ste 100
Juneau, AK 99801-9508
Phone (907) 586-6838
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5710 | Medicaid | AK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5710 | AK | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1233187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233187200000",
"number": "1982842852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5636 GLACIER HWY STE 100",
"city": "JUNEAU",
"state": "AK",
"postal_code": "998019508",
"telephone_number": "907-586-6838",
"fax_number": "907-586-8114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5636 GLACIER HWY STE 100",
"city": "JUNEAU",
"state": "AK",
"postal_code": "998019508",
"telephone_number": "907-586-6838",
"fax_number": "907-586-8114"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERITSCKO",
"first_name": "MARIA",
"middle_name": "ARCILIA",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-29",
"last_updated": "2009-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "AK",
"license": "5710",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5710",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Juneau, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.