| Fcmhs | |
|
3830 S Cushman St Fairbanks AK 99701-7530 | |
| (907) 452-1575 | |
| (907) 455-5287 |
| Full Name | Fcmhs |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3830 S Cushman St, Fairbanks, Alaska |
| Authorized Official Name and Position | Darcie M Shaffer (MEDICAL BILLING MANAGER) |
| Authorized Official Contact | 9075631000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fcmhs 1423 Peger Rd Fairbanks AK 99709-5169 Ph: (907) 371-1300 | Fcmhs 3830 S Cushman St Fairbanks AK 99701-7530 Ph: (907) 452-1575 |
| NPI Number | 1023445871 |
|---|---|
| Provider Enumeration Date | 10/10/2013 |
| Last Update Date | 02/03/2021 |
| Certification Date | 02/03/2021 |
| Medicare PECOS PAC ID | 6406085562 |
|---|---|
| Medicare Enrollment ID | O20140212001626 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023445871 | NPI | - | NPPES |
| 1596091 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Linda Laverne Keddington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760675953 PECOS PAC ID: 6204923493 Enrollment ID: I20170623002254 |
| Provider Name | Dianna L Rehn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1609251669 PECOS PAC ID: 6608100581 Enrollment ID: I20190626002610 |
| Provider Name | Virginia Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609326594 PECOS PAC ID: 3476977901 Enrollment ID: I20200716003260 |
| Provider Name | Curt E Wengel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801276027 PECOS PAC ID: 3274838750 Enrollment ID: I20200818004170 |
| Provider Name | Jason T Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639507551 PECOS PAC ID: 5092943456 Enrollment ID: I20201001003351 |
| Provider Name | Jonathon Edward Blum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558928580 PECOS PAC ID: 7012329154 Enrollment ID: I20201215001936 |
| Provider Name | Kristin Hansen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235732710 PECOS PAC ID: 7517379340 Enrollment ID: I20201218000997 |
| Provider Name | Paul L Gaines |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235575762 PECOS PAC ID: 4183986268 Enrollment ID: I20210115001493 |
| Provider Name | Jessica Estes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487632709 PECOS PAC ID: 7113959867 Enrollment ID: I20210129000794 |
| Provider Name | Marieke Nmn Heatwole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841804234 PECOS PAC ID: 0446655310 Enrollment ID: I20210817000326 |
| Provider Name | Jared John Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659860724 PECOS PAC ID: 1951634641 Enrollment ID: I20210921000725 |
| Provider Name | Susan B Matthews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922000736 PECOS PAC ID: 9638115264 Enrollment ID: I20211028003171 |
| Provider Name | Eli T Michael |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073009379 PECOS PAC ID: 6901296250 Enrollment ID: I20211201001469 |
| Provider Name | Larry W Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487319869 PECOS PAC ID: 9335539428 Enrollment ID: I20211203001471 |
| Provider Name | Myra L Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053807073 PECOS PAC ID: 8022368703 Enrollment ID: I20220106000780 |
| Provider Name | Paige Ann Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982051728 PECOS PAC ID: 0749574325 Enrollment ID: I20220208001442 |
| Provider Name | Lauren R Krahling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831679703 PECOS PAC ID: 1355738378 Enrollment ID: I20220421001722 |
| Provider Name | Amanda L Nalewaja |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235760703 PECOS PAC ID: 4385025444 Enrollment ID: I20220720002228 |
| Provider Name | Amber L Brownell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851950406 PECOS PAC ID: 3375929516 Enrollment ID: I20220926002428 |
| Provider Name | Katherine Jean Robins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831127117 PECOS PAC ID: 4082682547 Enrollment ID: I20221130001039 |
| Provider Name | Toni Brent |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821379561 PECOS PAC ID: 2668633728 Enrollment ID: I20230417002191 |
| Provider Name | Emma E Steinzeig |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144845744 PECOS PAC ID: 3375909963 Enrollment ID: I20230524002697 |
| Provider Name | Christian Mortenson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285890053 PECOS PAC ID: 6305193731 Enrollment ID: I20230905003945 |
| Provider Name | Erum R Ali |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851890875 PECOS PAC ID: 2264792068 Enrollment ID: I20230922001347 |
| Provider Name | Derek Hook |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700282571 PECOS PAC ID: 3274851183 Enrollment ID: I20230925003625 |
| Provider Name | Hannah D Mckinney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942920525 PECOS PAC ID: 9638526171 Enrollment ID: I20231106001967 |
| Provider Name | Daniel B Waters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518743236 PECOS PAC ID: 3779930227 Enrollment ID: I20231106002245 |
| Provider Name | Lisa A Enea |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477330751 PECOS PAC ID: 3870940109 Enrollment ID: I20231108002243 |
| Provider Name | Lavalda J Lyons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992587125 PECOS PAC ID: 1759733967 Enrollment ID: I20240123002918 |
| Provider Name | Kimberly M Kirkup |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639855844 PECOS PAC ID: 3971955113 Enrollment ID: I20240123003996 |
Fbx Fairbanks Behavior Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3245 Craft Ave, Fairbanks, AK 99709 Phone: 907-378-3434 Fax: 907-374-0820 | |
Pacific Rim Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1211 Cushman St Ste 200, Fairbanks, AK 99701 Phone: 907-452-5252 Fax: 907-452-6233 | |
Fairbanks Community Behavioral Health Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3830 S Cushman St, Fairbanks, AK 99701 Phone: 907-452-1575 Fax: 907-455-5287 | |
Making A Difference Support Services, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1867 Airport Way Ste 200, Fairbanks, AK 99701 Phone: 907-750-7169 Fax: 907-490-4469 | |
Rachel A Kacsur Lcsw Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 535 2nd Ave, Suite 207b, Fairbanks, AK 99701 Phone: 907-455-0250 Fax: 907-455-0250 | |
Beringia Mental Health Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 225 Wendell St, Ste B, Fairbanks, AK 99701 Phone: 907-455-4140 Fax: 907-455-4119 |