Joshua John Baumgartner
Individual provider Active NPI Counselor · Fairbanks, AK
NPI 1366869018 · NPPES record last updated Mar 19, 2014
Key facts
- NPI
- 1366869018
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 7033117 (AK)
- Practice address
- 1825 Marika Rd
Fairbanks, AK 99709-5521 - Phone
- (907) 474-0890
- Fax
- (907) 474-3621
- NPI assigned
- Mar 19, 2014
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7033117 | AK | MD | Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 7033117 | AK | Yes |
Addresses
Primary practice location
1825 Marika Rd
Fairbanks, AK 99709-5521
Mailing address
1825 Marika Rd
Fairbanks, AK 99709-5521
Phone (907) 474-0890
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MH3237 | Medicaid | AK |
Other providers in Fairbanks, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.