Northern Neurology Consultants, LLC.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

433242 Issued in AK

Legal business name

NORTHERN NEUROLOGY CONSULTANTS, LLC.

Practice address

3650 Lake Otis Pkwy
Suite 205
Anchorage, AK 99508-5207

Phone

(907) 563-1565

Fax

(907) 561-1541

NPI assigned

Aug 12, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Jayesh Makim, MD

Title

President

Phone

(907) 561-1565

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720080377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 241889",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995241889",
            "telephone_number": "907-563-1777",
            "fax_number": "907-561-7464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 LAKE OTIS PKWY",
            "address_2": "SUITE 205",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085207",
            "telephone_number": "907-563-1565",
            "fax_number": "907-561-1541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN NEUROLOGY CONSULTANTS, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAKIM",
        "authorized_official_first_name": "JAYESH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "907-561-1565",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "AK",
            "license": "433242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Internal Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.