NPIMap

Organization Active NPI

Fairbanks Anesthesia Inc.

  • Anesthesiology Physician
  • Fairbanks, AK
National Provider Identifier
1629098140
Registry record updated Nov 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
FAIRBANKS ANESTHESIA INC.
Practice address
1650 Cowles St
Fairbanks, AK 99701-5998
Phone
(800) 945-9877
Fax
(801) 432-2670
NPI assigned
Jul 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2016

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

Authorized official

Name
David Russell Flory, MD
Title
President
Phone
(800) 945-9877

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

1650 Cowles St
Fairbanks, AK 99701-5998

Mailing address

PO Box 3750
Salt Lake City, UT 84110-3750
Phone (800) 945-9877

Other identifiers 1

IdentifierTypeStateIssuer
MDG720MedicaidAK

National Provider Directory

National Provider Directory

Locations

1255 Airport Way
Ste 202
Fairbanks, AK 99701

1650 Cowles St
#100
Fairbanks, AK 99701
Phone (907) 451-8761

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478649600000",
    "number": "1629098140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3750",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841103750",
            "telephone_number": "800-945-9877",
            "fax_number": "801-432-2670"
        },
        {
            "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": "800-945-9877",
            "fax_number": "801-432-2670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRBANKS ANESTHESIA INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2016-11-09",
        "status": "A",
        "authorized_official_last_name": "FLORY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "800-945-9877",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MDG720",
            "state": "AK"
        }
    ],
    "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 Nov 9, 2016; 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.