Active NPI
Diane A Little Eagle
- Acupuncturist
- Fairbanks, AK
National Provider Identifier
1235581885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- ACUA25
- Practice address
- 3550 Airport Way
4
Fairbanks, AK 99709-4772 - Phone
- (907) 479-2331
- NPI assigned
- Jul 7, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Acupuncturist | 171100000X | ACUA25 | AK | Primary |
Addresses
Primary practice location
3550 Airport Way
4
Fairbanks, AK 99709-4772
Mailing address
3550 Airport Way
4
Fairbanks, AK 99709
Phone (907) 479-2331
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1643831 | Medicaid | AK |
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 |
|---|---|---|---|
| ACUA25 | AK | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467849600000",
"number": "1235581885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3550 AIRPORT WAY",
"address_2": "4",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "99709",
"telephone_number": "907-479-2331",
"fax_number": "907-479-0164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3550 AIRPORT WAY",
"address_2": "4",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997094772",
"telephone_number": "907-479-2331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LITTLE EAGLE",
"first_name": "DIANE",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-07",
"last_updated": "2016-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "AK",
"license": "ACUA25",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1643831",
"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 Jul 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.