MS. CANDACE ELIDA CARROLL (NPI# 1982726360) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982726360 |
| Entity Type | Individual |
| Full Name | MS. CANDACE ELIDA CARROLL |
| Practice Address |
1221 3rd Ave Fairbanks AK 99701-4239 |
| Practice Telephone | 9073780836 |
| Practice Fax Number | 9073743973 |
| Mailing Telephone | 9073780836 |
| Mailing Fax Number | 9073743973 |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 100585 | AK | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | ASSISTED LIVING LICENSE N | 100585 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659935120 | Candace Janell Carroll | Massage Therapist | 1010 Carbon Ct Unit F, Erie, CO 80516-8403 | 2019-04-30 |
| Street Address |
1221 3RD AVE |
| City | FAIRBANKS |
| State | AK |
| Zip Code | 99701-4239 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114363298 | Wild Iris Comfort Care | Assisted Living Facility | 1221 3rd Ave, Fairbanks, AK 99701-4239 | 2013-05-16 |
| 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 | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255961215 | Zachery Jones | Assisted Living Facility | 32 Craig Ave, Fairbanks, AK 99701-3527 | 2020-01-17 |
| 1457880064 | Frontier Assisted Living LLC | Assisted Living Facility | 1015 Evergreen St, Fairbanks, AK 99709-4306 | 2017-06-07 |
| 1497167894 | Borealis Assisted Living, LLC | Assisted Living Facility | 1521 Hilton Ave, Fairbanks, AK 99701-4015 | 2014-05-20 |
| 1174961668 | Hope Haven Assisted Living LLC | Assisted Living Facility | 1511 21st Ave, Fairbanks, AK 99701-6443 | 2013-06-06 |
| 1134455397 | Farmers Loop Home, LLC | Assisted Living Facility | 1002 Senate Loop, 1002 Senate Loop, Fairbanks, AK 99712-1130 | 2009-10-22 |
| 1922333228 | Olivia's House, Inc. | Assisted Living Facility | 593 Goldstreak Rd, Fairbanks, AK 99712-2009 | 2009-10-05 |
| 1588871628 | Country Estates Inc | Assisted Living Facility | 240 Peregrine Drive, Fairbanks, AK 99712 | 2007-05-17 |
| 1356555239 | Caring Bridges Assisted Living Home Inc | Assisted Living Facility | 107 7th Ave Unit1, Fairbanks, AK 99701-5063 | 2007-05-09 |
| 1891914453 | Rocking Years | Assisted Living Facility | 1913 Jack St, Fairbanks, AK 99709-4111 | 2007-04-24 |
| 1821217423 | Rocking Years Assisted Living II | Assisted Living Facility | 3291 Jefferson Dr, Fairbanks, AK 99709-5037 | 2007-04-24 |
| Find all providers in FAIRBANKS | ||||
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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.