NPIMap

Organization Active NPI

Chief Andrew Issac Health Center

  • Community/Behavioral Health Agency
  • Fairbanks, AK
National Provider Identifier
1083258677
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
CHIEF ANDREW ISSAC HEALTH CENTER
Practice address
1717 W Cowles St
Fairbanks, AK 99701-5926
Phone
(907) 451-6682
NPI assigned
Nov 6, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2025

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

Authorized official

Name
Jacoline Bergstrom
Title
Ex. Director of H.S.
Phone
(907) 452-8251

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1717 W Cowles St
Fairbanks, AK 99701-5926

Mailing address

122 1St Ave Ste 106
Fairbanks, AK 99701-4871
Phone (907) 452-8251

National Provider Directory

National Provider Directory
Tax ID family
Tanana Chiefscon38 organizations share this tax ID, including this one

Other organizations with this tax ID 37

Organizations that report the same tax identification number in the National Provider Directory.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1572998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745539200000",
    "number": "1083258677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 1ST AVE STE 106",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014871",
            "telephone_number": "907-452-8251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 W COWLES ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997015926",
            "telephone_number": "907-451-6682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIEF ANDREW ISSAC HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-06",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A",
        "authorized_official_last_name": "BERGSTROM",
        "authorized_official_first_name": "JACOLINE",
        "authorized_official_title_or_position": "EX. DIRECTOR OF H.S.",
        "authorized_official_telephone_number": "907-452-8251"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 25, 2025; 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.