Active NPI
Connor David Puetzer
- Behavior Technician
- Fairbanks, AK
National Provider Identifier
1346929684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1521 Hilton Ave
Fairbanks, AK 99701-4015 - Phone
- (907) 371-1300
- NPI assigned
- Jul 13, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
1521 Hilton Ave
Fairbanks, AK 99701-4015
Mailing address
4020 Folker St
Anchorage, AK 99508-5386
Phone (907) 653-1000
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": "1689206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689206400000",
"number": "1346929684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4020 FOLKER ST",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995085386",
"telephone_number": "907-653-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1521 HILTON AVE",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997014015",
"telephone_number": "907-371-1300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUETZER",
"first_name": "CONNOR",
"middle_name": "DAVID",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-07-13",
"last_updated": "2023-07-13",
"certification_date": "2023-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"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 Jul 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.