SURGERY CENTER OF FAIRBANKS LLC (NPI# 1255652285) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1255652285 |
Entity Type | Organization |
Organization Name | SURGERY CENTER OF FAIRBANKS LLC |
Practice Address |
2310 Peger Road Fairbanks AK 99709 |
Mailing Address |
1905 Cowles St Fairbanks AK 99701-5914 |
Practice Telephone | 9074792663 |
Mailing Telephone | 9074792663 |
Enumeration Date | 2010-06-14 |
Last Update Date | 2010-11-29 |
Authorized Official Name | DR. MARK A WADE (OWNER) |
Authorized Official Telephone | 9074792663 |
Authorized Official Credential | M.D. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
AK | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AK | HEALTH FACILITIES LICENSING AND CERTIFICATION | ASC-013 | 01 |
AK | AK BUSINESS LICENSE | 929695 | 01 |
Street Address |
2310 PEGER ROAD |
City | FAIRBANKS |
State | AK |
Zip Code | 99709 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255946810 | Beacon Monitoring Professional Services | Technician, Other | 745 Staffordshire Rd, Fairbanks, AK 99709 | 2020-09-10 |
1235629544 | Fairbanks Healing Space | Health Educator | 3875 Geist Road, Suite E #136, Fairbanks, AK 99709 | 2018-05-11 |
1609395409 | Shawn K Goggins | Counselor | 1423 Peger Road, Fairbanks, AK 99709 | 2017-09-12 |
1710433347 | Jay Titus | Technician/Technologist | 2884 Marina Drive, Fairbanks, AK 99709 | 2016-09-01 |
1710391610 | Hannah Summerfelt | Dentist | 3539 Thomas St, Fairbanks, AK 99709 | 2014-06-18 |
1629407325 | Diane Louise Mitchell | Nurse Practitioner | 4650 Harvard Cir, Fairbanks, AK 99709 | 2013-11-04 |
1407147929 | Christina Martz | Counselor | 1270 Summet Drive, Fairbanks, AK 99709 | 2011-05-02 |
1962661835 | John Leo Hughes Jr Jr. | Dentist | 3437 Airport Way, Suite 205, Fairbanks, AL 99709 | 2008-06-05 |
1508042417 | Katherine E Johnson, Md PC | Ophthalmology | 2485 Chief William Drive, Suite 100, Fairbanks, AK 99709 | 2008-01-10 |
1245449362 | David Kirk Smith | Chiropractor | 899 Chena Pump Road, Suite B, Fairbanks, AK 99709 | 2007-05-22 |
Find all providers in zip 99709 |
Taxonomy Code | 261QA1903X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Ambulatory Surgical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184016461 | Ww Enterprise, LLC | Clinic/Center | 2485 Chief William Dr, Fairbanks, AK 99709-4873 | 2015-02-24 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932676343 | Exexias Metrita - Anchorage LLC | Clinic/Center | 3074 Mountain View Dr Ste 193, Anchorage, AK 99501-3144 | 2018-10-24 |
1073009304 | Susitna Surgery Center LLC | Clinic/Center | 2490 S Woodworth Loop Ste 100, Palmer, AK 99645-7410 | 2018-07-10 |
1144677840 | Arctic Surgery Center LLC | Clinic/Center | 1335 Gambell St, Anchorage, AK 99501-4629 | 2016-05-23 |
1922464874 | Asc North LLC | Clinic/Center | 6911 Debarr Rd, Anchorage, AK 99504-1806 | 2016-01-07 |
1679998025 | Surgery Center of Kenai | Clinic/Center | 100 Trading Bay Dr, Kenai, AK 99611-7716 | 2014-02-21 |
1649534843 | Surgery Center of Wasilla, LLC | Clinic/Center | 3190 E Meridian Park Loop Ste 111, Wasilla, AK 99654-7422 | 2012-07-02 |
1710207998 | Providence Surgery Centers LLC | Clinic/Center | 3831 Piper St. Suite S-110, Anchorage, AK 99508 | 2010-06-10 |
1770605214 | Anchorage Endoscopy Center, LLC | Clinic/Center | 2841 Debarr Rd Ste 51, Anchorage, AK 99508-2932 | 2007-04-04 |
1316942048 | Alaska Spine Institute Surgery Center, LLC | Clinic/Center | 3801 Lake Otis Pkwy Ste 100, Anchorage, AK 99508-5234 | 2005-06-17 |
1184195877 | Alpine Surgicenter, LLC | Clinic/Center | 3801 Lake Otis Pkwy, Anchorage, AK 99508-5234 | 2018-12-06 |
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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.