Frontier St. Elias LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

FRONTIER ST. ELIAS LLC

Practice address

1015 Evergreen St
Fairbanks, AK 99709-4306

Phone

(541) 990-9911

Fax

(907) 328-2203

NPI assigned

Jul 23, 2024

Organization subpart

No

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

Authorized official

Name

Lisa Lynnetter Defoyd

Title

Owner/Administrator

Phone

(541) 990-9911

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1721692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721692800000",
    "number": "1245068089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 EVERGREEN ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997094306",
            "telephone_number": "541-990-9911",
            "fax_number": "907-328-2203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 EVERGREEN ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997094306",
            "telephone_number": "541-990-9911",
            "fax_number": "907-328-2203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4910 Palo Verde Ave",
            "address_purpose": "LOCATION",
            "city": "Fairbanks",
            "state": "AK",
            "postal_code": "997093212",
            "country_code": "US",
            "telephone_number": "541-990-9911",
            "fax_number": "907-328-2203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FRONTIER ST. ELIAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-23",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A",
        "authorized_official_last_name": "DEFOYD",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "LYNNETTER",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "541-990-9911"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; 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.