Active NPI
The Childrens Clinic Inc
- Pediatrics Physician
- Anchorage, AK
National Provider Identifier
1376529610
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 26446
- 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
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Daniel Edward Tulip, MD
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 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
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0120 | Medicaid | AK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AK
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210114001135 | AK | Part B Supplier - Mass Immunization (Roster Biller Only) | 4183037070 | Practice locations: Anchorage, AK |
National Provider Directory
National Provider DirectoryLocations
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.
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": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0120",
"state": "AK"
}
],
"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.