NPIMap

Organization Active NPI

Nisma Therapy Services LLC

  • Speech-Language Pathologist
  • Fairbanks, AK
National Provider Identifier
1316678097
Registry record updated Dec 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
NISMA THERAPY SERVICES LLC
Practice address
102 10TH Ave
Fairbanks, AK 99701-5003
Phone
(907) 759-7697
Fax
(907) 600-5065
NPI assigned
Jun 22, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2025

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

Authorized official

Name
Ariana Bates
Title
Practice Director
Phone
(907) 759-7697

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

102 10TH Ave
Fairbanks, AK 99701-5003

Mailing address

102 10TH Ave
Fairbanks, AK 99701-5003
Phone (907) 759-7697

Other names 1

  • Nisma Therapy Services LLC Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231116002119 AK Part B Supplier - Clinic/Group Practice 7719334374 Receives reassigned benefits from 7 practitioners
Practice locations: Fairbanks, AK

National Provider Directory

National Provider Directory
Tax ID family
Nisma Therapy Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

102 10th Ave
Fairbanks, AK 99701
Phone (907) 415-9331

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1655856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766966400000",
    "number": "1316678097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 10TH AVE",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997015003",
            "telephone_number": "907-759-7697",
            "fax_number": "907-600-5065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 10TH AVE",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997015003",
            "telephone_number": "907-759-7697",
            "fax_number": "907-600-5065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NISMA THERAPY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-22",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A",
        "authorized_official_last_name": "BATES",
        "authorized_official_first_name": "ARIANA",
        "authorized_official_title_or_position": "PRACTICE DIRECTOR",
        "authorized_official_telephone_number": "907-759-7697"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nisma Therapy Services LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.