Donald Ives, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

3149 Issued in AK

Practice address

1405 Kellum St
Suite 300
Fairbanks, AK 99701-4189

Phone

(907) 452-8346

Fax

(907) 451-8346

NPI assigned

Feb 21, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jun 1, 2023 through Jun 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: donald.ivesmd.p3@direct.cvr.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Laser Vein Center of Fairbanks, LLC

  • Primary Care Clinic/Center
  • Fairbanks, AK
  • NPI 1124161716
  Authorized official Same address or phone
• Laser Vein Center of Fairbanks, LLC

  • Phlebology Physician
  • Fairbanks, AK
  • NPI 1235371360

  Family Medicine

  NPD (past) Authorized official

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1356316699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 440",
            "city": "ESTER",
            "state": "AK",
            "postal_code": "997250440",
            "telephone_number": "907-452-8346",
            "fax_number": "907-451-8346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 KELLUM ST",
            "address_2": "SUITE 300",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014189",
            "telephone_number": "907-452-8346",
            "fax_number": "907-451-8346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVES",
        "first_name": "DONALD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "3149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jace LLC
• Amani Ayisha Jackson
• Cassie Thacker Jackson, MASTER OF EDUCATION
• Megan Jackson, FNP-C

• Family Medicine Physician in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Family Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.