Active NPI
Donald Esau Charlie, CDC II,BHA II
- Counselor
- Fairbanks, AK
National Provider Identifier
1689797664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 1850
- Practice address
- 1408 19TH Ave
Fairbanks, AK 99701 - Phone
- (907) 459-3800
- Fax
- (907) 832-5477
- NPI assigned
- Apr 6, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 1850 | AK | Primary |
Addresses
Primary practice location
1408 19TH Ave
Fairbanks, AK 99701
Mailing address
PO Box 253
Nenana, AK 99760-0253
Phone (907) 832-5467
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1850 | AK | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689797664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 253",
"city": "NENANA",
"state": "AK",
"postal_code": "997600253",
"telephone_number": "907-832-5467",
"fax_number": "907-832-5477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1408 19TH AVE",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "99701",
"telephone_number": "907-459-3800",
"fax_number": "907-832-5477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHARLIE",
"first_name": "DONALD",
"middle_name": "ESAU",
"name_prefix": "Mr.",
"credential": "CDC II,BHA II",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "AK",
"license": "1850",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.