Celina Marie Clift, M. D.
Individual provider Active NPI Pediatrics Physician · Fairbanks, AK
NPI 1598081606 · NPPES record last updated Sep 22, 2016
Key facts
- NPI
- 1598081606
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 7852 (AK)
- Practice address
- 1001 Noble St
Fairbanks, AK 99701-4922 - Phone
- (907) 459-3500
- Fax
- (907) 459-3526
- NPI assigned
- Apr 14, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140120000303 | AK | Practitioner - Pediatric Medicine | 3971731902 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7852 | AK | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tanana Valley Clinic LLC | Current |
Accepting new patients | |
| Tanana Valley Clinic LLC | Current |
Accepting new patients |
Locations
1650 Cowles St
Fairbanks, AK 99701
Phone (907) 452-8181
1650 Cowles St
Fl 4
Fairbanks, AK 99701
1001 Noble St
Fairbanks, AK 99701
Phone (907) 276-2806
Interoperability endpoints
- celina.clift@direct.tananavalley.nextgenshare.com
- celina.clift@foundationhealth.cernerdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | 7852 | AK | Yes |
Addresses
Primary practice location
1001 Noble St
Fairbanks, AK 99701-4922
Mailing address
1001 Noble St
Fairbanks, AK 99701-4922
Phone (907) 459-3500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598611 | Medicaid | AK |
Other providers in Fairbanks, AK
- Clear Vision Optometry, Inc
- Nicole Cleaver
- Alexis Elizabeth Clemente
- Samantha Fay Clemons
- Mark Andrew Clifford
- Alma Clifton
- Elizabeth Megan Cline
- Robbi Cline
- Lindsay Carolyn Clough
- Johnny Richard Clyde
All providers in Fairbanks, AK · Pediatrics Physician in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 22, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.