Active NPI
Philip R Clark, HEARING AID DEALER
- Hearing Instrument Specialist
- Fairbanks, AK
National Provider Identifier
1184889677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- 78
- Practice address
- 29 College Rd Ste 6
Fairbanks, AK 99701-1739 - Phone
- (907) 451-4327
- Fax
- (907) 451-4325
- NPI assigned
- Jul 23, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | 78 | AK | Primary |
Addresses
Primary practice location
29 College Rd Ste 6
Fairbanks, AK 99701-1739
Mailing address
29 College Rd Ste 6
Fairbanks, AK 99701-1739
Phone (907) 451-4327
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 78 | AK | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northland Hearing Services, Inc. | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Hearing Aid Equipment
- Fairbanks, AK
- NPI 1619124534
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216771200000",
"number": "1184889677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29 COLLEGE RD STE 6",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997011739",
"telephone_number": "907-451-4327",
"fax_number": "907-451-4325"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 COLLEGE RD STE 6",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997011739",
"telephone_number": "907-451-4327",
"fax_number": "907-451-4325"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "PHILIP",
"middle_name": "R",
"name_prefix": "Mr.",
"credential": "HEARING AID DEALER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-23",
"last_updated": "2008-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "AK",
"license": "78",
"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 Jul 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.