Individual provider Active NPI

Suemin CHI, FNP-BC

  • Family Nurse Practitioner
  • Fairbanks, AK
National Provider Identifier
1639875255
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
198961 Issued in AK
Practice address
1717 W Cowles St
Fairbanks, AK 99701-5926
Phone
(907) 451-6682
NPI assigned
Feb 6, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X 198961 AK Primary

Addresses

Primary practice location

1717 W Cowles St
Fairbanks, AK 99701-5926

Mailing address

410 Shannon Dr
Fairbanks, AK 99701-3291
Phone (907) 687-0220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230727000047 TX Practitioner - Nurse Practitioner 6709247554 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tanana Chiefs ConferenceGroup PAC ID 9537050109, 148 clinicians

Practice addresses (Care Compare)

1717 W Cowles St
Fairbanks, AK 99701-5926
Phone (907) 451-6682

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
198961AKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tanana Chiefs Conference Multi-Specialty CurrentSince Mar 20, 2023 Accepting new patients
Tanana Chiefs Conference Multi-Specialty CurrentSince Mar 20, 2023 Accepting new patients

Locations

1717 W Cowles St
Fairbanks, AK 99701
Phone (907) 452-6682

Interoperability endpoints

  • Direct secure messaging: suemin.chi.1@15989.direct.athenahealth.com

Organizations & group practices 2

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": "1675641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1639875255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 SHANNON DR",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997013291",
            "telephone_number": "907-687-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 W COWLES ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997015926",
            "telephone_number": "907-451-6682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHI",
        "first_name": "SUEMIN",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-06",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "198961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

Verify at the official NPI Registry.