DAVID N AMPONG NPI 1104464460

NPI Information

  • NPI: 1104464460
  • Provider Name: DAVID N AMPONG
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Organization
  • :
  • CLIA Number: 02D2177251
  • Address: 1577 C ST STE 201
    ANCHORAGE, AK
    ZIP 99501
  • Phone: (907) 538-9958

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NPI Details

DAVID N AMPONG is a psychiatric/mental health nurse practitioner in Anchorage, AK. DAVID N AMPONG NPI is 1104464460. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

1577 C ST STE 201
ANCHORAGE, AK
ZIP 99501-164
Phone: (907) 538-9958
Fax: (907) 865-2433

The provider's authorized official is Jennifer Mcdermott .
The authorized official title is Credentialing Specialist and has the following contact phone number (505) 712-2662.

The CLIA number assigned to this NPI record is 02D2177251 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/18/2019 and was last updated on 5/20/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QR0405XClinic/CenterRehabilitation, Substance Use DisorderNo
2363LP0808XNurse PractitionerPsychiatric/Mental HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11701389MEDICAIDALASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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