Meadow Creek Healthcare LLC
Physician Assistant, Medical in Eagle River, AK. Organization (NPI-2).
Details
- NPI
- 1376835355
- Entity type
- Organization (NPI-2)
- Legal business name
- Meadow Creek Healthcare LLC
- Organization subpart
- No
- Enumeration date
- May 9, 2011
- Last updated
- May 9, 2011
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | 423 | AK | Yes |
Other names
- Meadow Creek Dermatology (Doing Business As)
Practice location
16839 Park Place StSame
Eagle River, AK 99577-7819
Phone 907-694-3303 · Fax 907-694-4773
Mailing address
16839 Park Place StSame
Eagle River, AK 99577-7819
Phone 907-694-3303 · Fax 907-694-4773
Authorized official
Thomas A Fenger
Owner
9076943303
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Medical Physician Assistant providers in Eagle River, AK
- Kerry A Anson, PA-C, ATCNPI 1902150139
- Eagle River Primary CareNPI 1235319450
- Cheryl K Fitzgerald, PA-CNPI 1033248786
- Richard Rodd WehlingNPI 1780184929
- John Andrew Winczura, PA-CNPI 1336270347
All 6 Medical Physician Assistant providers in Eagle River · All 934 providers in Eagle River
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