Individual provider Active NPI

Owen Quigley Hanley, MD

  • Internal Medicine Physician
  • Fairbanks, AK
National Provider Identifier
1629077938
Registry record updated Dec 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
AA1350 Issued in AK
Practice address
1650 Cowles St
Fairbanks, AK 99701-5998
Phone
(907) 458-5680
NPI assigned
Jul 19, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X AA1350 AK Primary

Addresses

Primary practice location

1650 Cowles St
Fairbanks, AK 99701-5998

Mailing address

PO Box 71659
Chest Medicine Fairbanks, PC
Fairbanks, AK 99707-1659
Phone (907) 456-3750

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1350AKMDClinical Social Worker
AA1350AKMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chest Medicine Fairbanks,P.C PastSince Jul 1, 1998 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.

NPI Registry JSON

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292457600000",
    "number": "1629077938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 71659",
            "address_2": "CHEST MEDICINE FAIRBANKS, PC",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997071659",
            "telephone_number": "907-456-3750",
            "fax_number": "907-451-1701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COWLES ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997015998",
            "telephone_number": "907-458-5680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANLEY",
        "first_name": "OWEN",
        "middle_name": "QUIGLEY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2010-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AK",
            "license": "AA1350",
            "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 Dec 16, 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.