NPIMap

Organization Active NPI

The Childrens Clinic Inc

  • Pediatrics Physician
  • Anchorage, AK
National Provider Identifier
1376529610
Registry record updated Oct 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
26446 Issued in AK
Legal business name
THE CHILDRENS CLINIC INC
Practice address
4001 Dale St
Ste 213
Anchorage, AK 99508-5496
Phone
(907) 562-2944
Fax
(907) 562-6321
NPI assigned
Dec 19, 2005
Last updated
Oct 5, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2011

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

Authorized official

Name
Daniel Edward Tulip, MDNPI 1528044898
Title
President
Phone
(907) 562-2944

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X 26446 AK Primary

Addresses

Primary practice location

4001 Dale St
Ste 213
Anchorage, AK 99508-5496

Mailing address

4001 Dale St
Ste 213
Anchorage, AK 99508-5496
Phone (907) 562-2944

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210114001135 AK Part B Supplier - Mass Immunization (Roster Biller Only) 4183037070 Practice locations: Anchorage, AK

National Provider Directory

National Provider Directory

Locations

4001 Dale St
Ste 213
Anchorage, AK 99508
Phone (907) 562-2944

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317772800000",
    "number": "1376529610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 DALE ST",
            "address_2": "STE 213",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085496",
            "telephone_number": "907-562-2944",
            "fax_number": "907-562-6321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 DALE ST",
            "address_2": "STE 213",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085496",
            "telephone_number": "907-562-2944",
            "fax_number": "907-562-6321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CHILDRENS CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-19",
        "last_updated": "2011-10-05",
        "status": "A",
        "authorized_official_last_name": "TULIP",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "907-562-2944",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "AK",
            "license": "26446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2011; 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.