NPIMap

Organization Active NPI

Fairbanks Community Care Coordination

  • Case Management Agency
  • Fairbanks, AK
National Provider Identifier
1013684414
Registry record updated Aug 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
FAIRBANKS COMMUNITY CARE COORDINATION
Practice address
1902 Central Ave
Fairbanks, AK 99709-4223
Phone
(907) 398-7297
NPI assigned
Aug 24, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Miss Amanda EllisNPI 1053086736
Title
Owner/Administrator
Phone
(907) 398-7297

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

1902 Central Ave
Fairbanks, AK 99709-4223

Mailing address

PO Box 80929
Fairbanks, AK 99708-0929
Phone (907) 398-7297

Other names 1

  • Fairbanks Community Care Coordination Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629763200000",
    "number": "1013684414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80929",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997080929",
            "telephone_number": "907-398-7297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 CENTRAL AVE",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997094223",
            "telephone_number": "907-398-7297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRBANKS COMMUNITY CARE COORDINATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-24",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "907-398-7297",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fairbanks Community Care Coordination",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairbanks, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.