NPIMap

Organization Active NPI

Interior Alaska Orthopedic & Sports Medicine Inc

  • Specialist
  • Fairbanks, AK
National Provider Identifier
1386815678
Registry record updated Mar 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
INTERIOR ALASKA ORTHOPEDIC & SPORTS MEDICINE INC
Practice address
2310 Peger Rd Ste 105
Fairbanks, AK 99709-5305
Phone
(907) 479-2663
Fax
(907) 479-2691
NPI assigned
Mar 14, 2008
Last updated
Mar 27, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2012

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

Authorized official

Name
Dr. Mark A Wade, MDNPI 1356307458
Title
Docter
Phone
(907) 479-2663

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

2310 Peger Rd Ste 105
Fairbanks, AK 99709-5305

Mailing address

2310 Peger Rd Ste 105
Fairbanks, AK 99709-5305
Phone (907) 479-2663

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

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": "1205452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332806400000",
    "number": "1386815678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 PEGER RD STE 105",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997095305",
            "telephone_number": "907-479-2663",
            "fax_number": "907-479-2691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 PEGER RD STE 105",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997095305",
            "telephone_number": "907-479-2663",
            "fax_number": "907-479-2691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERIOR ALASKA ORTHOPEDIC & SPORTS MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-14",
        "last_updated": "2012-03-27",
        "status": "A",
        "authorized_official_last_name": "WADE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DOCTER",
        "authorized_official_telephone_number": "907-479-2663",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "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 Mar 27, 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.

Verify at the official NPI Registry.