NPIMap

Organization Active NPI

Fairbanks Native Association

Doing business as Gateway to Recovery

  • Substance Abuse Rehabilitation Facility
  • Fairbanks, AK
National Provider Identifier
1134764913
Registry record updated Nov 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
FAIRBANKS NATIVE ASSOCIATION
Doing business as
Gateway to Recovery
Practice address
650 Younker CT
Fairbanks, AK 99701-7586
Phone
(907) 456-1053
Fax
(907) 452-1001
NPI assigned
Nov 15, 2019
Last updated
Nov 15, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2019

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

Authorized official

Name
Perry Ahsogeak
Title
Behavioral Health Director
Phone
(907) 452-6251

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X NU Primary

Addresses

Primary practice location

650 Younker CT
Fairbanks, AK 99701-7586

Mailing address

315 Wendell Ave
Fairbanks, AK 99701-4837
Phone (907) 452-6251

Other identifiers 1

IdentifierTypeStateIssuer
1696799MedicaidAK

Other names 1

  • Gateway to Recovery Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Fairbanks Native Association6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

315 Wendell Ave
Fairbanks, AK 99701
Phone (907) 452-1648

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/fairbanksnative/r4/

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1573776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573776000000",
    "number": "1134764913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 WENDELL AVE",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014837",
            "telephone_number": "907-452-6251",
            "fax_number": "907-452-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 YOUNKER CT",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997017586",
            "telephone_number": "907-456-1053",
            "fax_number": "907-452-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRBANKS NATIVE ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-15",
        "last_updated": "2019-11-15",
        "status": "A",
        "authorized_official_last_name": "AHSOGEAK",
        "authorized_official_first_name": "PERRY",
        "authorized_official_title_or_position": "BEHAVIORAL HEALTH DIRECTOR",
        "authorized_official_telephone_number": "907-452-6251"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1696799",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gateway to Recovery",
            "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 Nov 15, 2019; 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.