Fairbanks Memorial Hospital

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

Legal business name

FAIRBANKS MEMORIAL HOSPITAL

Practice address

1650 Cowles St
Fairbanks, AK 99701-5998

Phone

(907) 452-8181

NPI assigned

Jun 8, 2006

Last updated

Nov 25, 2013By the provider in NPPES

Organization subpart

Yes

Parent organization

BANNER HEALTHAs reported in NPPES

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

Authorized official

Name

Dennis E Dahlen

Title

Vice President/Finance

Phone

(602) 747-4000

Specialties & licenses 2

Addresses

Other identifiers 3

Tax ID family

Fairbanks Memorial Hospital LLC7 organizations share this tax ID, including this one

Part of

M E Lee MD

Other organizations with this tax ID 6

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

• Fairbanks Memorial Hospital

  dba Fairbanks Memorial Lifeline

  • Customized Equipment (DME)
  • Fairbanks, AK
  • NPI 1255092896
  NPD tax ID
• Fairbanks Memorial Hospital, LLC

  • Community/Retail Pharmacy
  • Fairbanks, AK
  • NPI 1083165740
  NPD tax ID
• Fairbanks Memorial Hospital, LLC

  dba Fairbanks Memorial Hospital Pharmacy

  • Institutional Pharmacy
  • Fairbanks, AK
  • NPI 1447701966
  NPD tax ID
• Fairbanks Memorial Hospital, LLC

  • General Acute Care Hospital
  • Fairbanks, AK
  • NPI 1720537178
  NPD tax ID
• Fairbanks Memorial Hospital, LLC

  • Community Based Hospice Care Agency
  • Fairbanks, AK
  • NPI 1881145571
  NPD tax ID
• Fairbanks Memorial Hospital, LLC

  • Home Health Agency
  • Fairbanks, AK
  • NPI 1912458696
  NPD tax ID

Member of 1

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

• Banner Health

  dba Banner Hospice of Northern Colorado

  • Community Based Hospice Care Agency
  • Greeley, CO
  • NPI 1407409964

  Member Of

  NPD member

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/d2e61489-9680-4a3d-974a-fc8d705fc283/

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Banner Health

  dba Fairbanks Infusion Pharmacy

  • Home Infusion Therapy Pharmacy
  • Fairbanks, AK
  • NPI 1003008277
  NPPES parent name

Practitioners 6

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.

• Milan Bajmoczi, M.D.

  • Vascular Surgery Physician
  • Fairbanks, AK
  • NPI 1700012598
  NPD (past)
• Lisa Carole Hill, RD

  • Registered Dietitian
  • Fairbanks, AK
  • NPI 1588636526
  NPD (past)
• Laurie Jeanne Struthers, RD

  • Registered Dietitian
  • Fairbanks, AK
  • NPI 1154394567
  NPD (past)
• Eric L Kerley, MD

  • Hospitalist Physician
  • Sumter, SC
  • NPI 1770533523
  NPD (past)
• Carol Ada Pierce, MD

  • Surgery Physician
  • Portage, WI
  • NPI 1538177480
  NPD (past)
• Kimberly A Sherrill, MD

  • Psychiatry Physician
  • Little Rock, AR
  • NPI 1689668089
  NPD (past)

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385337600000",
    "number": "1184665663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 N 12TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COWLES ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997015998",
            "telephone_number": "907-452-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRBANKS MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BANNER HEALTH",
        "enumeration_date": "2006-06-08",
        "last_updated": "2013-11-25",
        "status": "A",
        "authorized_official_last_name": "DAHLEN",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "VICE PRESIDENT/FINANCE",
        "authorized_official_telephone_number": "602-747-4000"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1021279 (PSYCH)",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1005551",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HS03AW",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fairbanks Medical Imaging LLC
• Fairbanks Memorial Cardiology Center
• Fairbanks Memorial Cardiology Center, LLC
• Fairbanks Memorial Cardiology Clinic, LLC
• Fairbanks Memorial Home Medical Equipment, LLC
• Fairbanks Memorial Hospital (Fairbanks Memorial Lifeline)
• Fairbanks Memorial Hospital (Fairbanks Memorial Hospital Home Care)
• Fairbanks Memorial Hospital (Banner Home Medical Equipment FMH)
• Fairbanks Memorial Hospital, LLC
• Fairbanks Memorial Hospital, LLC (Fairbanks Memorial Hospital Pharmacy)

• General Acute Care Hospital in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• General Acute Care Hospital in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2013; 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.