Individual provider Active NPI

Christopher Trudgen, RN

  • Registered Nurse
  • Fairbanks, AK
National Provider Identifier
1124739636
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
118274 Issued in AK
Practice address
70 Steelhead Rd
Fairbanks, AK 99709-3035
Phone
(907) 750-6785
NPI assigned
Dec 6, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X 118274 AK Primary

Addresses

Primary practice location

70 Steelhead Rd
Fairbanks, AK 99709-3035

Mailing address

1653 Market St
Fairbanks, AK 99709-5120
Phone (408) 251-2433

Other identifiers 1

IdentifierTypeStateIssuer
118274OtherAKPRIVATE PAY OR PRIVATE INSURANCE

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL LILY5GHZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
118274AKMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Emmanel Assisted Living Home West, Inc. CurrentSince Dec 13, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1124739636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1653 MARKET ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997095120",
            "telephone_number": "408-251-2433",
            "fax_number": "877-620-9084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 STEELHEAD RD",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997093035",
            "telephone_number": "907-750-6785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUDGEN",
        "first_name": "CHRISTOPHER",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-06",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "AK",
            "license": "118274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE PAY OR PRIVATE INSURANCE",
            "identifier": "118274",
            "state": "AK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "LILY5GHZ",
            "affiliation": "N",
            "address_1": "70 Steelhead Rd",
            "city": "Fairbanks",
            "state": "AK",
            "country_code": "US",
            "postal_code": "997093035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Dec 6, 2022; 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.