TANANA VALLEY CLINIC LLC (NPI# 1245708668) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245708668 |
| Entity Type | Organization |
| Organization Name | TANANA VALLEY CLINIC LLC |
| Practice Address |
1919 Lathrop St Fairbanks AK 99701-5937 |
| Mailing Address |
Po Box 73720 Fairbanks AK 99707-3720 |
| Practice Telephone | 9074593500 |
| Practice Fax Number | 9074593526 |
| Mailing Telephone | 1907459350 |
| Enumeration Date | 2018-11-03 |
| Last Update Date | 2018-11-03 |
| Authorized Official Name | STEPHEN PAUL LESLIE (CFO) |
| Authorized Official Telephone | 9074583310 |
| Is Organization Subpart | Y |
| Parent Organization Name | FOUNDATION HEALTH LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | 1656211 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063980118 | Tanana Valley Clinic LLC | Clinic/Center | 1101 Noble St, Fairbanks, AK 99701-4924 | 2018-11-07 |
| 1073081287 | Tanana Valley Clinic LLC | Clinic/Center | 1405 Kellum St, Fairbanks, AK 99701-4189 | 2018-11-06 |
| 1073081485 | Tanana Valley Clinic LLC | Clinic/Center | 570 Riverstone Way, Fairbanks, AK 99709-2940 | 2018-11-05 |
| 1922559558 | Tanana Valley Clinic LLC | Clinic/Center | 1001 Noble St, Fairbanks, AK 99701-4948 | 2016-10-19 |
| Street Address |
1919 LATHROP ST |
| City | FAIRBANKS |
| State | AK |
| Zip Code | 99701-5937 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699774299 | Letha C Archer | Pediatrics | 1919 Lathrop St, Suite 100, Fairbanks, AK 99701-5937 | 2005-07-18 |
| 1275084626 | Jeffrey W. Kilgore Dmd PC | Dentist | 1919 Lathrop St, Ste: 211, Fairbanks, AK 99701-5937 | 2016-10-20 |
| 1992256341 | Otter Dental | Dentist | 1919 Lathrop St, Suite 211, Fairbanks, AK 99701-5937 | 2016-10-20 |
| 1467909218 | Rebecca Rengel | Physical Therapist | 1919 Lathrop St, Ste 123, Fairbanks, AK 99701-5937 | 2016-09-08 |
| 1538613203 | Brent Little | Physical Therapist | 1919 Lathrop St, Suite 123, Fairbanks, AK 99701-5937 | 2016-08-10 |
| 1396298626 | Nicholas Nzioka Ndetti Jr. | Pharmacist | 1919 Lathrop St, Suite 109, Fairbanks, AK 99701-5937 | 2016-08-03 |
| 1366829699 | Karolina Priebe | Nurse Practitioner | 1919 Lathrop St, Suite 101, Fairbanks, AK 99701-5937 | 2015-05-06 |
| 1124405618 | David Boyd | Specialist/Technologist | 1919 Lathrop St, Suite 123, Fairbanks, AK 99701-5937 | 2015-05-04 |
| 1679903140 | Heidi Wood | Physical Therapist | 1919 Lathrop St, #123, Fairbanks, AK 99701-5937 | 2013-11-20 |
| 1376982918 | Fairbanks Orthodontic Group, A Professional Corporation | Clinic/Center | 1919 Lathrop St, Suite 102, Fairbanks, AK 99701-5937 | 2013-06-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659984987 | Resource Center for Parents & Children, Inc. | Social Worker | 726 26th Ave, Suite #2, Fairbanks, AK 99701 | 2020-08-26 |
| 1134738982 | Aaron Paul Sarauer | Behavior Technician | 3121 Lathrop St., Fairbanks, AK 99701 | 2020-07-28 |
| 1437715505 | Fabienne Rose Marie Siddall | Case Manager/Care Coordinator | 122 1st Avenue, Fairbanks, AK 99701 | 2019-05-14 |
| 1902461957 | Jacqueline Marie Rahm | Counselor | Family Centered Services of Alaska - Rtc, 3101 Lathrop St., Fairbanks, AK 99701 | 2019-05-06 |
| 1821588989 | Corrie Wilson | Nurse Practitioner | 1025 Barnette Street, Fairbanks, AK 99701 | 2018-05-15 |
| 1922519305 | Sarishma Sangeeta Lal | Registered Nurse | 815 2nd Ave Ste 122, Fairbanks, AK 99701 | 2017-10-12 |
| 1245690569 | Christine L Simko | Naturopath | 1275 Sadler Way, Ste 100 Rm 147, Fairbanks, AK 99701 | 2016-02-29 |
| 1932581600 | Jennifer Davis | Registered Nurse | 1025 West Barnette St., Fairbanks, AK 99701 | 2015-06-18 |
| 1700272705 | John D. Zipperer Jr Md, LLC | Clinic/Center | 751 Old Richardson Hwy., Fairbanks, AK 99701 | 2015-04-07 |
| 1578957460 | Mara Justine Becker | Physician Assistant | 1717 W. Cowles St, Fairbanks, AK- ALASKA 99701 | 2015-03-27 |
| Find all providers in zip 99701 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063980118 | Tanana Valley Clinic LLC | Clinic/Center | 1101 Noble St, Fairbanks, AK 99701-4924 | 2018-11-07 |
| 1942751631 | Fairbanks Memorial Cardiology Clinic, LLC | Clinic/Center | 1650 Cowles St Dept 61a, Fairbanks, AK 99701-5907 | 2016-10-18 |
| 1073081287 | Tanana Valley Clinic LLC | Clinic/Center | 1405 Kellum St, Fairbanks, AK 99701-4189 | 2018-11-06 |
| 1073081485 | Tanana Valley Clinic LLC | Clinic/Center | 570 Riverstone Way, Fairbanks, AK 99709-2940 | 2018-11-05 |
| 1922559558 | Tanana Valley Clinic LLC | Clinic/Center | 1001 Noble St, Fairbanks, AK 99701-4948 | 2016-10-19 |
| 1770933871 | Arctic Pain Relief Center, LLC | Clinic/Center | 1901 Airport Way Ste 102, Fairbanks, AK 99701-4049 | 2016-06-20 |
| 1962803908 | Banner Health Physicians Alaska LLC | Clinic/Center | 1001 Noble St, Fairbanks, AK 99701-4948 | 2014-09-09 |
| 1225273667 | Margaret M Wilson | Clinic/Center | 1408 19th Ave., Chief Andrew Isaac Health Clinic, Fairbanks, AK 99701 | 2008-12-15 |
| 1386763290 | Fairbanks Memorial Physician Specialities | Clinic/Center | 1650 Cowles St, Fairbanks, AK 99701-5925 | 2007-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487265690 | Whole Family Integrated Wellness LLC | Clinic/Center | 600 E 36th Ave Ste 300, Anchorage, AK 99503-4168 | 2020-08-11 |
| 1528600947 | Southcentral Foundation | Clinic/Center | 6901 E Tudor Rd Ste 8, Anchorage, AK 99507-1254 | 2019-10-17 |
| 1558899807 | Arctic Chiropractic and Physical Medicine Kodiak | Clinic/Center | 2975 Mill Bay Rd Ste A, Kodiak, AK 99615-7831 | 2017-05-31 |
| 1811420391 | Southcentral Foundation | Clinic/Center | 1021 E 3rd Ave, Anchorage, AK 99501-6102 | 2017-04-11 |
| 1689021776 | Southcentral Foundation | Clinic/Center | 755 A St, Anchorage, AK 99501-3625 | 2016-05-18 |
| 1194152058 | Peninsula Pediatric Therapy, Inc. | Clinic/Center | 7335 Palmer Wasilla Hwy, Palmer, AK 99645-6007 | 2013-10-08 |
| 1154591451 | La Integrative Primary Care Centre Inc | Clinic/Center | 8811 Toloff St, Anchorage, AK 99507-3848 | 2008-03-03 |
| 1962572099 | Juneau Family Birth Center | Clinic/Center | 3225 Hospital Dr Unit 106, Juneau, AK 99801-7863 | 2006-11-08 |
| 1912954272 | Southcentral Foundation | Clinic/Center | 101 Airport Road, Iliamna, AK 99606 | 2006-05-30 |
| 1063467223 | Southcentral Foundation | Clinic/Center | 10 Dnr Road, Mcgrath, AK 99627 | 2006-05-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.