NPIMap

Organization Active NPI

Fairbanks Community Imaging, LLC

  • Diagnostic Radiology Physician
  • Fairbanks, AK
National Provider Identifier
1245456557
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
FAIRBANKS COMMUNITY IMAGING, LLC
Practice address
1314 22ND Ave.
Fairbanks, AK 99701
Phone
(907) 563-3700
NPI assigned
Apr 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. John McCormick, M.D.NPI 1144291295
Title
Manager
Phone
(907) 563-3700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

1314 22ND Ave.
Fairbanks, AK 99701

Mailing address

4100 Lake Otis Pkwy Ste 309
Anchorage, AK 99508-5231

National Provider Directory

National Provider Directory

Locations

4100 Lake Otis Pkwy
Ste 309
Anchorage, AK 99508

1314 22ND Ave
Fairbanks, AK 99701
Phone (907) 563-3700

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245456557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 LAKE OTIS PKWY STE 309",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 22ND AVE.",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "99701",
            "telephone_number": "907-563-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRBANKS COMMUNITY IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCCORMICK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "907-563-3700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "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 Aug 22, 2020; 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.