Active NPI
Tara Crosslan
- Case Manager/Care Coordinator
- Fairbanks, AK
National Provider Identifier
1437480068
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 542 4TH Ave
Suite 234
Fairbanks, AK 99701-4714 - Phone
- (907) 456-4524
- Fax
- (907) 456-5524
- NPI assigned
- Jan 21, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
542 4TH Ave
Suite 234
Fairbanks, AK 99701-4714
Mailing address
610 E 5TH Ave
Anchorage, AK 99501-2731
Phone (907) 258-3498
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CM0115 | Medicaid | AK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267747200000",
"number": "1437480068",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "610 E 5TH AVE",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995012731",
"telephone_number": "907-258-3498",
"fax_number": "907-279-0171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "542 4TH AVE",
"address_2": "SUITE 234",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997014714",
"telephone_number": "907-456-4524",
"fax_number": "907-456-5524"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROSSLAN",
"first_name": "TARA",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-01-21",
"last_updated": "2010-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "CM0115",
"state": "AK"
}
],
"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 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.