Organization Active NPI

McKinley Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Fairbanks, AK
National Provider Identifier
1063133759
Registry record updated Sep 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
MCKINLEY SURGERY CENTER, LLC
Practice address
3745 Geist Rd
Fairbanks, AK 99709-3554
Phone
(907) 373-3700
Fax
(907) 373-3799
NPI assigned
Sep 9, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2022

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

Authorized official

Name
Stan James
Title
Ceo/Owner
Phone
(907) 373-3700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

3745 Geist Rd
Fairbanks, AK 99709-3554

Mailing address

3765 E. Blue Lupine Dr Ste B
Wasilla, AK 99654
Phone (907) 373-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240416000650 AK Part B Supplier - Ambulatory Surgical Center 9638518228 Practice locations: Fairbanks, AK

Ambulatory surgical center certification: CCN 02C0001024

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
McKinley Surgery Center
Certification status
Active
Provider type (POS)
Ambulatory surgical center
Participating since
Dec 11, 2025
Last certification
Dec 11, 2025
Ownership / control type
Proprietary
Facility address
3745 Geist Road
Fairbanks, AK 99709

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
02D2274065McKinley Surgery Center, LLC3745 Geist Road, Fairbanks, AK 99709Certificate of waiverDec 21, 2026

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

3765 E Blue Lupine Dr
Ste B
Wasilla, AK 99654

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": "1662681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662681600000",
    "number": "1063133759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3765 E. BLUE LUPINE DR STE B",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "99654",
            "telephone_number": "907-373-3700",
            "fax_number": "907-373-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3745 GEIST RD",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997093554",
            "telephone_number": "907-373-3700",
            "fax_number": "907-373-3799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCKINLEY SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-09",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "STAN",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "907-373-3700"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

Verify at the official NPI Registry.