Individual provider Active NPI

Mary Jane Gay Ackerman, RN

  • Inpatient Obstetric Registered Nurse
  • Fairbanks, AK
National Provider Identifier
1275504086
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Inpatient Obstetric Registered NurseTaxonomy code 163WX0003X
License
26NO09155000 Issued in NJ
Practice address
4985 Palo Verde Ave
Fairbanks, AK 99709-3213
Phone
(907) 452-2923
NPI assigned
Jan 30, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Inpatient Obstetric Registered Nurse 163WX0003X 26NO09155000 NJ Primary

Addresses

Primary practice location

4985 Palo Verde Ave
Fairbanks, AK 99709-3213

Mailing address

1060 Gaffney Rd #7740
Commander, USA-Meddac-Ak, Attn: McUc-MMD-QM
Fort Wainwright, AK 99703-7440
Phone (907) 353-5418

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
26NO09155000NJMDInpatient Obstetric Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1275504086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 GAFFNEY RD #7740",
            "address_2": "COMMANDER, USA-MEDDAC-AK, ATTN: MCUC-MMD-QM",
            "city": "FORT WAINWRIGHT",
            "state": "AK",
            "postal_code": "997037440",
            "telephone_number": "907-353-5418",
            "fax_number": "907-353-4845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4985 PALO VERDE AVE",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997093213",
            "telephone_number": "907-452-2923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKERMAN",
        "first_name": "MARY JANE",
        "middle_name": "GAY",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-30",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Obstetric, Inpatient",
            "state": "NJ",
            "license": "26NO09155000",
            "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 Jul 13, 2026; 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.