Active NPI
Michael Fitzgerald
- Registered Nurse
- Ketchikan, AK
National Provider Identifier
1730580606
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 16201
- Practice address
- 925 Jackson St
Ketchikan, AK 99901-5735 - Phone
- (907) 617-1567
- NPI assigned
- Sep 10, 2014
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 16201 | AK | Primary |
Addresses
Primary practice location
925 Jackson St
Ketchikan, AK 99901-5735
Mailing address
925 Jackson St
Ketchikan, AK 99901-5735
Phone (907) 617-1567
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 |
|---|---|---|---|
| 16201 | AK | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410307200000",
"number": "1730580606",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "925 JACKSON ST",
"city": "KETCHIKAN",
"state": "AK",
"postal_code": "999015735",
"telephone_number": "907-617-1567"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "925 JACKSON ST",
"city": "KETCHIKAN",
"state": "AK",
"postal_code": "999015735",
"telephone_number": "907-617-1567"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZGERALD",
"first_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-09-10",
"last_updated": "2014-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "AK",
"license": "16201",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ketchikan, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.