FAIRBANKS PAIN CONSULTING, LLC (NPI# 1932436672) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932436672 |
| Entity Type | Organization |
| Organization Name | FAIRBANKS PAIN CONSULTING, LLC |
| Practice Address |
1919 Lathrop St Suite 221 Fairbanks AK 99701-5937 |
| Mailing Address |
3030 Davis Rd C7 Fairbanks AK 99709-5233 |
| Practice Telephone | 9074585638 |
| Practice Fax Number | 9074586415 |
| Mailing Telephone | 9074600222 |
| Mailing Fax Number | 9074586415 |
| Enumeration Date | 2009-11-16 |
| Last Update Date | 2009-11-16 |
| Authorized Official Name | DR. SHAN JIANG (PRESIDENT) |
| Authorized Official Telephone | 9074585638 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP3300X |
Clinic/Center Specialization: Pain |
124884 | AK | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | MD2985 | 05 |
| Street Address |
1919 LATHROP ST SUITE 221 |
| 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 |
| 1245708668 | Tanana Valley Clinic LLC | Clinic/Center | 1919 Lathrop St, Fairbanks, AK 99701-5937 | 2018-11-03 |
| 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 |
| 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 | 261QP3300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Pain |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174988539 | Primary Pain Solutions LLC | Clinic/Center | 7810 Canal St, Anchorage, AK 99502-4261 | 2015-12-29 |
| 1336524651 | Arctic Chiropractic and Physical Medicine | Clinic/Center | 107 A Alex Hately, Bethel, AK 99559-3466 | 2015-07-28 |
| 1457433658 | Pioneer Peak Surgery Center, LLC | Clinic/Center | 3035 Palmer Wasilla Hwy, Suite 301, Wasilla, AK 99654-7234 | 2006-10-19 |
| 1750807988 | Lofthus, LLC | Clinic/Center | 16611 Farm Ave, Eagle River, AK 99577-7667 | 2017-08-18 |
| 1669907606 | Medical Group of Alaska | Clinic/Center | 3190 E Meridian Park Loop, Suite 206b, Wasilla, AK 99654-7422 | 2017-04-27 |
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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.