Active NPI
Mathilda Huntington, PA-C
- Medical Physician Assistant
- Fairbanks, AK
National Provider Identifier
1366423204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 348
- Practice address
- 1717 West Cowles St
Fairbanks, AK 99701-5903 - Phone
- (907) 451-6682
- NPI assigned
- Nov 8, 2005
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 348 | AK | Primary |
Addresses
Primary practice location
1717 West Cowles St
Fairbanks, AK 99701-5903
Mailing address
1717 West Cowles Street
Fairbanks, AK 99701-5903
Phone (907) 451-6682
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 348 | AK | MD | Ph.D. Medical Genetics |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354492800000",
"number": "1366423204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1717 WEST COWLES STREET",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997015903",
"telephone_number": "907-451-6682"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1717 WEST COWLES ST",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997015903",
"telephone_number": "907-451-6682"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUNTINGTON",
"first_name": "MATHILDA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-08",
"last_updated": "2012-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "AK",
"license": "348",
"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 Dec 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.