Active NPI
Roy Fukuoka
- Certified Registered Nurse Anesthetist
- Palmer, AK
National Provider Identifier
1629067590
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 281
- Practice address
- 2500 S Woodworth Loop
Palmer, AK 99645-8984 - Phone
- (907) 227-0162
- NPI assigned
- Oct 13, 2005
- 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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 281 | AK | Primary |
Addresses
Primary practice location
2500 S Woodworth Loop
Palmer, AK 99645-8984
Mailing address
8737 Inyo Cir
Eagle River, AK 99577-9402
Phone (907) 227-0162
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287100800000",
"number": "1629067590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8737 INYO CIR",
"city": "EAGLE RIVER",
"state": "AK",
"postal_code": "995779402",
"telephone_number": "907-227-0162"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 S WOODWORTH LOOP",
"city": "PALMER",
"state": "AK",
"postal_code": "996458984",
"telephone_number": "907-227-0162"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUKUOKA",
"first_name": "ROY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-13",
"last_updated": "2010-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "AK",
"license": "281",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palmer, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.