NPIMap

Organization Active NPI

Tanana Chiefs Conference

  • Multi-Specialty Clinic/Center
  • Fairbanks, AK
National Provider Identifier
1629287958
Registry record updated May 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
TANANA CHIEFS CONFERENCE
Practice address
122 1St Ave
Suite 600
Fairbanks, AK 99701-4803
Phone
(907) 452-8251
NPI assigned
May 22, 2007
Last updated
May 4, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2026

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

Authorized official

Name
Jacoline Bergstrom
Title
HS Director
Phone
(907) 452-8251

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X
Ambulatory Surgical Clinic/Center 261QA1903X
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

122 1St Ave
Suite 600
Fairbanks, AK 99701-4803

Mailing address

122 1St Ave
Suite 600
Fairbanks, AK 99701-4803
Phone (907) 452-8251

Other identifiers 1

IdentifierTypeStateIssuer
MDG215MedicaidAK

National Provider Directory

National Provider Directory
Tax ID family
Old Minto Family Recovery Camp38 organizations share this tax ID, including this one

Other organizations with this tax ID 37

Organizations that report the same tax identification number in the National Provider Directory.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777852800000",
    "number": "1629287958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 1ST AVE",
            "address_2": "SUITE 600",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014803",
            "telephone_number": "907-452-8251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 1ST AVE",
            "address_2": "SUITE 600",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014803",
            "telephone_number": "907-452-8251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TANANA CHIEFS CONFERENCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A",
        "authorized_official_last_name": "BERGSTROM",
        "authorized_official_first_name": "JACOLINE",
        "authorized_official_title_or_position": "HS DIRECTOR",
        "authorized_official_telephone_number": "907-452-8251"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MDG215",
            "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 May 4, 2026; 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.