Individual provider Active NPI

Rafael Bultron, CDC1

  • Addiction (Substance Use Disorder) Counselor
  • Anchorage, AK
National Provider Identifier
1265760938
Registry record updated Nov 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
3001 C St
Anchorage, AK 99503-3913
Phone
(907) 273-4080
Fax
(907) 273-4005
NPI assigned
Nov 18, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

3001 C St
Anchorage, AK 99503-3913

Mailing address

3001 C St
Anchorage, AK 99503-3913
Phone (907) 273-4080

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

NPI Registry JSON

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

{
    "created_epoch": "1258502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258502400000",
    "number": "1265760938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 C ST",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995033913",
            "telephone_number": "907-273-4080",
            "fax_number": "907-273-4005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 C ST",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995033913",
            "telephone_number": "907-273-4080",
            "fax_number": "907-273-4005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULTRON",
        "first_name": "RAFAEL",
        "credential": "CDC1",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-18",
        "last_updated": "2009-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2009; 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.