Individual provider Active NPI

Larry Allen Harikian, MD

  • General Practice Physician
  • Fairbanks, AK
National Provider Identifier
1215019138
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
2223 Issued in AK
Practice address
1867 Airport Way
Ste 130B
Fairbanks, AK 99701-4056
Phone
(907) 452-2178
Fax
(907) 452-3524
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 2223 AK Primary

Addresses

Primary practice location

1867 Airport Way
Ste 130B
Fairbanks, AK 99701-4056

Mailing address

1867 Airport Way
Ste 130B
Fairbanks, AK 99701-4056
Phone (907) 452-2178

Other identifiers 1

IdentifierTypeStateIssuer
MD22232MedicaidAK

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2223AKMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214179200000",
    "number": "1215019138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1867 AIRPORT WAY",
            "address_2": "STE 130B",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014056",
            "telephone_number": "907-452-2178",
            "fax_number": "907-452-3524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1867 AIRPORT WAY",
            "address_2": "STE 130B",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014056",
            "telephone_number": "907-452-2178",
            "fax_number": "907-452-3524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARIKIAN",
        "first_name": "LARRY",
        "middle_name": "ALLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2008-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AK",
            "license": "2223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD22232",
            "state": "AK"
        }
    ],
    "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 Jun 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.

Verify at the official NPI Registry.