Individual provider Active NPI

Debra Denise Allen, FNP-C

  • Family Nurse Practitioner
  • Fairbanks, AK
National Provider Identifier
1184885246
Registry record updated Jun 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
333 Issued in AK
Practice address
1275 Sadler Way
Fairbanks, AK 99701-3171
Phone
(907) 451-6142
NPI assigned
Jun 21, 2008
Last updated
Jun 21, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 333 AK Primary

Addresses

Primary practice location

1275 Sadler Way
Fairbanks, AK 99701-3171

Mailing address

1077 Willow Grouse Rd
Fairbanks, AK 99712-1246
Phone (907) 457-5048

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090818000817 AK Practitioner - Nurse Practitioner 2567516073 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Timothy W Teslow MD PCGroup PAC ID 5597750026, 2 clinicians

Practice addresses (Care Compare)

1275 Sadler Way
Suite 102
Fairbanks, AK 99701-3175
Phone (907) 457-7874

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
333AKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Steese Immediate Care Current Accepting new patients
Timothy W Teslow, M.D., P.C. CurrentSince May 20, 2009 Accepting new patients

Locations

1275 Sadler Way
Ste 101
Fairbanks, AK 99701
Phone (907) 374-6602

1275 Sadler Way
Ste 101B
Fairbanks, AK 99701

1275 Sadler Way
Ste 102
Fairbanks, AK 99701
Phone (907) 451-6142

Interoperability endpoints

  • Direct secure messaging: debra.allen.1@31576.direct.athenahealth.com

Organizations & group practices 2

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1214006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214006400000",
    "number": "1184885246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1077 WILLOW GROUSE RD",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997121246",
            "telephone_number": "907-457-5048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 SADLER WAY",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997013171",
            "telephone_number": "907-451-6142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "DEBRA",
        "middle_name": "DENISE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-21",
        "last_updated": "2008-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

Verify at the official NPI Registry.