NPIMap

Organization Active NPI

Interior AIDS Association

  • Methadone Clinic
  • Fairbanks, AK
National Provider Identifier
1306483755
Registry record updated Dec 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
INTERIOR AIDS ASSOCIATION
Practice address
710 3Rd Avenue
Fairbanks, AK 99701-4455
Phone
(907) 452-4222
Fax
(907) 452-8176
NPI assigned
Dec 4, 2019
Last updated
Dec 4, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2019

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

Authorized official

Name
Anna Nelson
Title
Executive Director
Phone
(907) 452-4222

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X NU Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X NU

Addresses

Primary practice location

710 3Rd Avenue
Fairbanks, AK 99701-4455

Mailing address

P.O. Box 71248
Fairbanks, AK 99707-1248
Phone (907) 452-4222

Other identifiers 1

IdentifierTypeStateIssuer
1697598MedicaidAK

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1575417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575417600000",
    "number": "1306483755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 71248",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997071248",
            "telephone_number": "907-452-4222",
            "fax_number": "907-452-8176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 3RD AVENUE",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014455",
            "telephone_number": "907-452-4222",
            "fax_number": "907-452-8176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERIOR AIDS ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-04",
        "last_updated": "2019-12-04",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "907-452-4222"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1697598",
            "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 Dec 4, 2019; 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.