Jodi Ann Irvine

Individual provider Active NPI Case Manager/Care Coordinator · Fairbanks, AK

NPI 1386850469 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1386850469
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
117 Slater Dr
Fairbanks, AK 99701-3427
Phone
(907) 451-0389
Fax
(907) 451-0210
NPI assigned
May 15, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Fairbanks Resource Agency Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X AK Yes

Addresses

Primary practice location

117 Slater Dr
Fairbanks, AK 99701-3427

Mailing address

805 Airport Way
Fairbanks, AK 99701-6039
Phone (907) 451-0389

Other identifiers

IdentifierTypeStateIssuer
2528MedicaidAK

Other providers in Fairbanks, AK

All providers in Fairbanks, AK · Case Manager/Care Coordinator in Alaska

Sources for this page

Verify at the official NPI Registry.