| Tanana Chiefs Conference | |
|
1717 W Cowles St Fairbanks AK 99701-5926 | |
| (907) 451-6682 | |
| Not Available |
| Full Name | Tanana Chiefs Conference |
|---|---|
| Speciality | Clinic/Center |
| Location | 1717 W Cowles St, Fairbanks, Alaska |
| Authorized Official Name and Position | Jacoline Bergstrom (DIRECTOR OF HEALTH SERVICES) |
| Authorized Official Contact | 9074528251 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tanana Chiefs Conference 201 1st Ave Ste 300 Fairbanks AK 99701-4848 Ph: (907) 452-8251 | Tanana Chiefs Conference 1717 W Cowles St Fairbanks AK 99701-5926 Ph: (907) 451-6682 |
| NPI Number | 1821201278 |
|---|---|
| Provider Enumeration Date | 05/08/2007 |
| Last Update Date | 10/27/2023 |
| Medicare PECOS PAC ID | 9537050109 |
|---|---|
| Medicare Enrollment ID | O20050111000954 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821201278 | NPI | - | NPPES |
| Provider Name | Stephen E Livingston |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619996923 PECOS PAC ID: 4587562855 Enrollment ID: I20031223000477 |
| Provider Name | Leif Thompson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780667105 PECOS PAC ID: 6608776992 Enrollment ID: I20040112000362 |
| Provider Name | Elizabeth D. Ferucci |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1598705121 PECOS PAC ID: 2163418567 Enrollment ID: I20040421001677 |
| Provider Name | Bryan G Wachter |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1801827027 PECOS PAC ID: 2961481718 Enrollment ID: I20040715001184 |
| Provider Name | Theresa Marie Kouadio |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1720034556 PECOS PAC ID: 0941294748 Enrollment ID: I20040817000628 |
| Provider Name | Molly Hutsinpiller |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1508834474 PECOS PAC ID: 8628050135 Enrollment ID: I20041124000112 |
| Provider Name | Brian J Mcmahon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427093574 PECOS PAC ID: 7517925738 Enrollment ID: I20041220000998 |
| Provider Name | Janet L Wilkinson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316962053 PECOS PAC ID: 4183682354 Enrollment ID: I20041221000233 |
| Provider Name | Max D Walker |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356366090 PECOS PAC ID: 1557329679 Enrollment ID: I20041221000609 |
| Provider Name | Nigel Wappett |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1669462206 PECOS PAC ID: 2365482734 Enrollment ID: I20050504001138 |
| Provider Name | Robert Gibson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700904406 PECOS PAC ID: 3678516218 Enrollment ID: I20050606000438 |
| Provider Name | Randall L Plant |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1225063993 PECOS PAC ID: 0042254088 Enrollment ID: I20050610000658 |
| Provider Name | Val D Christensen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1235228859 PECOS PAC ID: 5294634853 Enrollment ID: I20050610000749 |
| Provider Name | Billy W Carpenter |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1023056272 PECOS PAC ID: 1557372117 Enrollment ID: I20060510000312 |
| Provider Name | Lisa J Townshend-bulson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528111010 PECOS PAC ID: 6002915154 Enrollment ID: I20070630000081 |
| Provider Name | Susan Mermelstein |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1841315124 PECOS PAC ID: 2062509086 Enrollment ID: I20071107000329 |
| Provider Name | Youssef K Barbour |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588846042 PECOS PAC ID: 5991888067 Enrollment ID: I20080212000715 |
| Provider Name | Juan Grimaldos |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1902833742 PECOS PAC ID: 0446201560 Enrollment ID: I20080401000902 |
| Provider Name | Gina Y Escobar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962560268 PECOS PAC ID: 6406744267 Enrollment ID: I20090316000257 |
| Provider Name | Christopher T Todd |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508872441 PECOS PAC ID: 7416851084 Enrollment ID: I20090324000478 |
| Provider Name | Peter A De Schweinitz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427085711 PECOS PAC ID: 1951375088 Enrollment ID: I20090327000456 |
| Provider Name | Stephen S Gerrish |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134137003 PECOS PAC ID: 3274636220 Enrollment ID: I20090413000059 |
| Provider Name | Dana Sue Mathis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568643831 PECOS PAC ID: 9739231549 Enrollment ID: I20090708000600 |
| Provider Name | Shannon Wiegand |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629080437 PECOS PAC ID: 4688572373 Enrollment ID: I20091023000553 |
| Provider Name | Tamara A Huntington |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700984275 PECOS PAC ID: 4486793825 Enrollment ID: I20091125000120 |
| Provider Name | Amy E Snedigar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447498704 PECOS PAC ID: 5193853398 Enrollment ID: I20100510000104 |
| Provider Name | Joanne M Wallis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265437172 PECOS PAC ID: 1153455381 Enrollment ID: I20100810000660 |
| Provider Name | Michael E Lamar |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1871571984 PECOS PAC ID: 8820175524 Enrollment ID: I20100812000997 |
| Provider Name | Rhonda C Smith |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1386677284 PECOS PAC ID: 7315061959 Enrollment ID: I20100902000780 |
| Provider Name | Neil Joseph Murphy |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1598878019 PECOS PAC ID: 4082738638 Enrollment ID: I20100902000903 |
| Provider Name | Howard L Katz |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1245271998 PECOS PAC ID: 3274657887 Enrollment ID: I20100903000476 |
| Provider Name | Gregory M Kisling |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508803867 PECOS PAC ID: 0749235133 Enrollment ID: I20100903000556 |
| Provider Name | Michael J Mcdonnell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033144639 PECOS PAC ID: 5890810196 Enrollment ID: I20100909000940 |
| Provider Name | Amalia R Steinberg |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1316109895 PECOS PAC ID: 8527249572 Enrollment ID: I20110223000752 |
| Provider Name | Beverly J Lemaster |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1902826597 PECOS PAC ID: 5890971246 Enrollment ID: I20110519000093 |
| Provider Name | Erin E Boklage |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1154575298 PECOS PAC ID: 7416018155 Enrollment ID: I20110721000859 |
| Provider Name | Rachel Kerford Lescher |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043480643 PECOS PAC ID: 7517138480 Enrollment ID: I20110926000584 |
| Provider Name | Kena K Desai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124285945 PECOS PAC ID: 3173794070 Enrollment ID: I20110927000022 |
| Provider Name | Steven J Jay |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1679644108 PECOS PAC ID: 5294901732 Enrollment ID: I20120104000439 |
| Provider Name | Elizabeth S Saltonstall |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154354678 PECOS PAC ID: 7416029426 Enrollment ID: I20120308000588 |
| Provider Name | James R Taylor |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1154484442 PECOS PAC ID: 6800058694 Enrollment ID: I20120423000722 |
| Provider Name | Leoa A Sanders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093853921 PECOS PAC ID: 6204091911 Enrollment ID: I20120703000124 |
| Provider Name | Carolyn D Click |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1447506266 PECOS PAC ID: 2466608880 Enrollment ID: I20120816000933 |
| Provider Name | Rachel L Stephan |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1215283668 PECOS PAC ID: 2860640620 Enrollment ID: I20120919000876 |
| Provider Name | Mark A Clifford |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003834086 PECOS PAC ID: 5092964213 Enrollment ID: I20121003000883 |
| Provider Name | Christina L Wright |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407862345 PECOS PAC ID: 5597664086 Enrollment ID: I20130520000173 |
| Provider Name | Kristen M Sublett |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1821340142 PECOS PAC ID: 1254572688 Enrollment ID: I20130729000306 |
| Provider Name | Laura L Shively |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1174797088 PECOS PAC ID: 1254568231 Enrollment ID: I20131219000400 |
| Provider Name | Jason A Capo |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1922212125 PECOS PAC ID: 0143464768 Enrollment ID: I20140221000474 |
| Provider Name | Annette M Hewitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225045727 PECOS PAC ID: 7618161878 Enrollment ID: I20140408001636 |
| Provider Name | Benjamin Walz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407098577 PECOS PAC ID: 7214176635 Enrollment ID: I20140513000716 |
| Provider Name | Deborah J Minnick-shearin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790899425 PECOS PAC ID: 1850515214 Enrollment ID: I20140605000823 |
| Provider Name | Christy S Pierce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639349798 PECOS PAC ID: 6507923919 Enrollment ID: I20140614000013 |
| Provider Name | Edward Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689905952 PECOS PAC ID: 8820214604 Enrollment ID: I20140731001194 |
| Provider Name | Prabhat Bhama |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1962415430 PECOS PAC ID: 6901024694 Enrollment ID: I20140821000393 |
| Provider Name | Eric Lim |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1396952560 PECOS PAC ID: 8527257302 Enrollment ID: I20141001002072 |
| Provider Name | Mindona I Billings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255764163 PECOS PAC ID: 0840512992 Enrollment ID: I20141201001516 |
| Provider Name | Graham Milam |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1669619425 PECOS PAC ID: 7113249061 Enrollment ID: I20141203001022 |
| Provider Name | Alisa Alexander |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215207253 PECOS PAC ID: 2365765187 Enrollment ID: I20150102000681 |
| Provider Name | Sylvia Slotnick |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1942619788 PECOS PAC ID: 4284957796 Enrollment ID: I20150107002430 |
| Provider Name | David B Trowbridge |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356367007 PECOS PAC ID: 9335338706 Enrollment ID: I20150127000514 |
| Provider Name | Lauren Christine Keller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730205196 PECOS PAC ID: 1355665019 Enrollment ID: I20150129000167 |
| Provider Name | Joseph Kennedy |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1013087063 PECOS PAC ID: 2860717444 Enrollment ID: I20150203001534 |
| Provider Name | Pamela S Gjertson |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1659328128 PECOS PAC ID: 4284732389 Enrollment ID: I20150226000403 |
| Provider Name | David S Warren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275924417 PECOS PAC ID: 1658697529 Enrollment ID: I20150312000321 |
| Provider Name | Theresa Bartoldus |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1871991661 PECOS PAC ID: 9931417029 Enrollment ID: I20151009002263 |
| Provider Name | Todd R Stephens |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1598725707 PECOS PAC ID: 2365346848 Enrollment ID: I20151201001281 |
| Provider Name | Margaret E Carlson Cosentino |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1568722197 PECOS PAC ID: 3375868029 Enrollment ID: I20160205000129 |
| Provider Name | Heidi Wood |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1679903140 PECOS PAC ID: 8921238684 Enrollment ID: I20160510000126 |
| Provider Name | Barbara Y Bifelt |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1083058861 PECOS PAC ID: 6709193568 Enrollment ID: I20160511000514 |
| Provider Name | Anne M Lilley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043243470 PECOS PAC ID: 6406874163 Enrollment ID: I20160512001548 |
| Provider Name | Mark Simon |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043207533 PECOS PAC ID: 3678474491 Enrollment ID: I20160607001532 |
| Provider Name | Vanessa A Venezia Heuer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851360838 PECOS PAC ID: 9739333709 Enrollment ID: I20160712002540 |
| Provider Name | Alexandr London |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184849242 PECOS PAC ID: 5395888051 Enrollment ID: I20160725002971 |
| Provider Name | Ai-ling Lin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982947479 PECOS PAC ID: 1052605482 Enrollment ID: I20160809000148 |
| Provider Name | Sarah M Doaty |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1215254818 PECOS PAC ID: 2668767211 Enrollment ID: I20160823000164 |
| Provider Name | Katrin Tsigonis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023302221 PECOS PAC ID: 4688828585 Enrollment ID: I20160823000944 |
| Provider Name | Abraham Tsigonis |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1881986115 PECOS PAC ID: 7012145022 Enrollment ID: I20160829002331 |
| Provider Name | Kimberly Sonderland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285918110 PECOS PAC ID: 5092982173 Enrollment ID: I20160831001040 |
| Provider Name | Janice Chen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841305208 PECOS PAC ID: 2163315276 Enrollment ID: I20160913000082 |
| Provider Name | Keir Fowler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700991163 PECOS PAC ID: 6406749928 Enrollment ID: I20160914000350 |
| Provider Name | Zachary Wayne Bear |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1124313614 PECOS PAC ID: 0446552913 Enrollment ID: I20160917000262 |
| Provider Name | Mark N Burton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508970971 PECOS PAC ID: 4587557780 Enrollment ID: I20160926000394 |
| Provider Name | David L Evans |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306010962 PECOS PAC ID: 8123185493 Enrollment ID: I20161003001792 |
| Provider Name | Claire Waite |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164537544 PECOS PAC ID: 0042221053 Enrollment ID: I20161112000004 |
| Provider Name | Jessica Ellen Panko |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366641060 PECOS PAC ID: 0547434664 Enrollment ID: I20161112000116 |
| Provider Name | Celine Siddall |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1538614862 PECOS PAC ID: 7618257783 Enrollment ID: I20161207000033 |
| Provider Name | Gabe V Schuldt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275758583 PECOS PAC ID: 0749326932 Enrollment ID: I20170421000011 |
| Provider Name | Joshua Tokita |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1548581234 PECOS PAC ID: 1658511597 Enrollment ID: I20170725000242 |
| Provider Name | Andrew L Cornelius |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1447426424 PECOS PAC ID: 1557541364 Enrollment ID: I20170725001514 |
| Provider Name | Rebecca Sturdevant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396802112 PECOS PAC ID: 0143120402 Enrollment ID: I20170803002864 |
| Provider Name | Morgan B Liddell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396003455 PECOS PAC ID: 2163734120 Enrollment ID: I20170829003116 |
| Provider Name | Gail Norton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336568252 PECOS PAC ID: 8022235845 Enrollment ID: I20170922000946 |
| Provider Name | Catherine A Crowe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497702781 PECOS PAC ID: 0446344741 Enrollment ID: I20171006002643 |
| Provider Name | Amanda Joy Cushing |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1518476910 PECOS PAC ID: 4284991498 Enrollment ID: I20171127000482 |
| Provider Name | Janet E Whatley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912187170 PECOS PAC ID: 6103995998 Enrollment ID: I20180105000210 |
| Provider Name | Audrey Frone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164975777 PECOS PAC ID: 0547523193 Enrollment ID: I20180412000252 |
| Provider Name | Jamie H Burford |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1093880841 PECOS PAC ID: 5799683967 Enrollment ID: I20180430001907 |
| Provider Name | Megan Gooding |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770070674 PECOS PAC ID: 8820233562 Enrollment ID: I20180514001201 |
| Provider Name | Ebrahim Paryavi |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1093982951 PECOS PAC ID: 1759605124 Enrollment ID: I20180911001784 |
| Provider Name | Abigail J Klager |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023496346 PECOS PAC ID: 8628381514 Enrollment ID: I20181030002384 |
| Provider Name | Ellie Marie Servia |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1710345806 PECOS PAC ID: 9739487042 Enrollment ID: I20181217000011 |
| Provider Name | Andrew Resseguie |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1366926883 PECOS PAC ID: 7315286192 Enrollment ID: I20190222002268 |
| Provider Name | Kurt Hediger |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1316060460 PECOS PAC ID: 5395087431 Enrollment ID: I20190422000700 |
| Provider Name | Thomas C Keller |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1225297997 PECOS PAC ID: 9537384011 Enrollment ID: I20190501001729 |
| Provider Name | Stephen Odegard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710335740 PECOS PAC ID: 7911290713 Enrollment ID: I20190610000362 |
| Provider Name | Phyllis Lynn Willis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922270958 PECOS PAC ID: 3678643228 Enrollment ID: I20190611001286 |
| Provider Name | Timothy Ryan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1063858215 PECOS PAC ID: 4486944741 Enrollment ID: I20190927001381 |
| Provider Name | Javaneh Lyons |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1477969640 PECOS PAC ID: 2163724980 Enrollment ID: I20191016000023 |
| Provider Name | Sadie M Marden |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1114312204 PECOS PAC ID: 4284948357 Enrollment ID: I20191106000228 |
| Provider Name | Rachel Kumari Sircar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629464284 PECOS PAC ID: 5799094231 Enrollment ID: I20191127000083 |
| Provider Name | Hunter M Keys |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649696279 PECOS PAC ID: 2668697624 Enrollment ID: I20200206000136 |
| Provider Name | Jennifer B Jacobs |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144660093 PECOS PAC ID: 8921390493 Enrollment ID: I20200210001316 |
| Provider Name | Jason Whipple |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982775979 PECOS PAC ID: 4284061904 Enrollment ID: I20200219000255 |
| Provider Name | Tessa C Hovenden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922528900 PECOS PAC ID: 5193096303 Enrollment ID: I20200409000555 |
| Provider Name | Carolyn Margaret Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487094207 PECOS PAC ID: 6305162157 Enrollment ID: I20200416002503 |
| Provider Name | Eliana Vasconcelos Mckee |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1376570879 PECOS PAC ID: 8527061365 Enrollment ID: I20200512002285 |
| Provider Name | Peter Harvey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710535380 PECOS PAC ID: 7214352798 Enrollment ID: I20200730002509 |
| Provider Name | Gwen Hobson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730504663 PECOS PAC ID: 9032336714 Enrollment ID: I20200804000551 |
| Provider Name | Mary Terra |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1437560299 PECOS PAC ID: 0941518609 Enrollment ID: I20200826000769 |
| Provider Name | Kara Emi Yoshida |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538770631 PECOS PAC ID: 0547678914 Enrollment ID: I20210423001090 |
| Provider Name | Katherine Cammack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588009187 PECOS PAC ID: 0244544674 Enrollment ID: I20210426001750 |
| Provider Name | Sara Gayle Hornberger |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1124050299 PECOS PAC ID: 2567484363 Enrollment ID: I20210511001641 |
| Provider Name | Angela Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174810691 PECOS PAC ID: 5395095939 Enrollment ID: I20210528000084 |
| Provider Name | Kyle Dexter |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1447725809 PECOS PAC ID: 3779828991 Enrollment ID: I20210601000531 |
| Provider Name | Monique Dase Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174796247 PECOS PAC ID: 1557591286 Enrollment ID: I20210628001657 |
| Provider Name | Jordan Charles Ross |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1417310681 PECOS PAC ID: 1951695188 Enrollment ID: I20210803000050 |
| Provider Name | Rebekah Macon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003401274 PECOS PAC ID: 9931503661 Enrollment ID: I20210803001881 |
| Provider Name | Ashley Lundgren Strum |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467795146 PECOS PAC ID: 9234434275 Enrollment ID: I20210927000031 |
| Provider Name | Daniel Michael Strum |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255674107 PECOS PAC ID: 3779889522 Enrollment ID: I20211005001231 |
| Provider Name | Nicole Barker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760848238 PECOS PAC ID: 0446642466 Enrollment ID: I20220124001802 |
| Provider Name | Sarah Hamilton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558091587 PECOS PAC ID: 1658749726 Enrollment ID: I20221121001943 |
| Provider Name | Charles Steiner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558337741 PECOS PAC ID: 9133024128 Enrollment ID: I20221121003398 |
| Provider Name | Michael Kwasinski |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1255362901 PECOS PAC ID: 6709196793 Enrollment ID: I20221122002024 |
| Provider Name | Frank J Novy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770517781 PECOS PAC ID: 8921029794 Enrollment ID: I20221122002509 |
| Provider Name | Kerry Wappett |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1982846267 PECOS PAC ID: 1254573108 Enrollment ID: I20221201002492 |
| Provider Name | Douglas Michael Herrin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1265896773 PECOS PAC ID: 0941594428 Enrollment ID: I20221214001834 |
| Provider Name | Katie K Garrity |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1437691771 PECOS PAC ID: 7517241094 Enrollment ID: I20221220000083 |
| Provider Name | Wendy Lau |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205363603 PECOS PAC ID: 2163774696 Enrollment ID: I20230414001835 |
| Provider Name | Kathleen M Russo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790784932 PECOS PAC ID: 1355301706 Enrollment ID: I20230417002104 |
| Provider Name | John Breeding |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1992748396 PECOS PAC ID: 0042228520 Enrollment ID: I20230612002301 |
| Provider Name | Karen Lynn Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306194576 PECOS PAC ID: 5890937726 Enrollment ID: I20230613001642 |
| Provider Name | Michael R Brumage |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871583716 PECOS PAC ID: 7315229853 Enrollment ID: I20230624000242 |
| Provider Name | William R Krueger |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881661783 PECOS PAC ID: 6406048636 Enrollment ID: I20230707000184 |
| Provider Name | Michael G Wallace |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1689615346 PECOS PAC ID: 0648207910 Enrollment ID: I20230718001691 |
| Provider Name | Suemin Chi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639875255 PECOS PAC ID: 6709247554 Enrollment ID: I20230727000047 |
| Provider Name | Michael E Larson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174054670 PECOS PAC ID: 2466700331 Enrollment ID: I20230901000380 |
| Provider Name | Michael Bergquist |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033644927 PECOS PAC ID: 5890065924 Enrollment ID: I20230920000541 |
| Provider Name | Luis-felipe Zavala |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1134817034 PECOS PAC ID: 8325492242 Enrollment ID: I20230927000188 |
| Provider Name | Linh Mai |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1942997408 PECOS PAC ID: 7113373077 Enrollment ID: I20231028000471 |
| Provider Name | Michelle T Dinh |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1386332856 PECOS PAC ID: 8527414283 Enrollment ID: I20231101000923 |
| Provider Name | Shawna Anne Victorino |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1740476126 PECOS PAC ID: 1850477787 Enrollment ID: I20231129000092 |
| Provider Name | Leslie Tester |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174784862 PECOS PAC ID: 3678922424 Enrollment ID: I20231206000326 |
| Provider Name | Lisabeth Bush |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912998097 PECOS PAC ID: 3678644663 Enrollment ID: I20240110004667 |
Polar Wind Medical Center, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1867 Airport Way Ste 140a, Fairbanks, AK 99701 Phone: 907-457-9355 Fax: 907-457-9356 | |
Alaska Occupational Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1919 Lathrop St Ste 203, Fairbanks, AK 99701 Phone: 907-456-2825 Fax: 907-451-0742 | |
University Of Alaska Fairbanks Center For Health & Counseling Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 612 N. Chandalar Dr., Fairbanks, AK 99775 Phone: 907-474-7043 Fax: 907-474-5777 | |
Joseph Daniel Grimes Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1650 Cowles St, Fairbanks, AK 99701 Phone: 907-458-3345 | |
Linda L Garcia Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1405 Kellum St Ste 201, Fairbanks, AK 99701 Phone: 907-378-8119 Fax: 907-488-5539 | |
Tanana Valley Clinic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1101 Noble St, Fairbanks, AK 99701 Phone: 907-459-3500 | |
Tanana Valley Clinic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1405 Kellum St, Fairbanks, AK 99701 Phone: 907-459-3500 |