Samuel a McConkey III MD PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

849 Issued in AK

Legal business name

SAMUEL A MCCONKEY III MD PC

Practice address

1521 Stacia St
Fairbanks, AK 99701-6135

Phone

(907) 456-4822

NPI assigned

Feb 2, 2007

Last updated

Dec 9, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Samuel A McConkey, MD

Title

Owner

Phone

(907) 456-7767

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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.

• Christi LB McWilliams, L.D.O.

  • Optician
  • Fairbanks, AK
  • NPI 1093920670
  NPD (past)
• Anita Mullins

  • Optometrist
  • Fairbanks, AK
  • NPI 1114935616
  NPD (past)

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291852800000",
    "number": "1578601340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 ILLINOIS ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997012910",
            "telephone_number": "907-456-7767",
            "fax_number": "907-456-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 STACIA ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997016135",
            "telephone_number": "907-456-4822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL A MCCONKEY III MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2010-12-09",
        "status": "A",
        "authorized_official_last_name": "MCCONKEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-456-7767",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AK",
            "license": "849",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD0849",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Theresa Lynann Salzman, PBT
• Crystalena Sam
• Samaritan Counseling Center
• Katina Beth Sammons
• Joseph Sample
• Holly Marie Sanborn, LPC
• Christionna Sanchez
• Jason Drew Sanders, RN
• Sherry Sanders
• Cessnie J Sanderson, CNA, CMA

• Ophthalmology Physician in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Ophthalmology Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.

Verify at the official NPI Registry.