Active NPI
Allan Roberts
- Registered Nurse
- Fairbanks, AK
National Provider Identifier
1609261601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 18084
- Practice address
- 1025 W Barnette St
Fairbanks, AK 99701-4539 - Phone
- (907) 451-1637
- Fax
- (907) 451-1611
- NPI assigned
- Apr 6, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 18084 | AK | Primary |
Addresses
Primary practice location
1025 W Barnette St
Fairbanks, AK 99701-4539
Mailing address
1025 W Barnette St
Fairbanks, AK 99701-4539
Phone (907) 451-1637
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18084 | AK | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of Alaska Department of Administration | Past | Accepting new patients |
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.
-
- Psychiatric Hospital
- Anchorage, AK
- NPI 1497842553
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428278400000",
"number": "1609261601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1025 W BARNETTE ST",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997014539",
"telephone_number": "907-451-1637",
"fax_number": "907-451-1611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1025 W BARNETTE ST",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997014539",
"telephone_number": "907-451-1637",
"fax_number": "907-451-1611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "ALLAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-04-06",
"last_updated": "2015-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "AK",
"license": "18084",
"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 Apr 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.