Organization Active NPI

Nick Sarrimanolis, M.D. LLC

  • Internal Medicine Physician
  • Fairbanks, AK
National Provider Identifier
1760665012
Registry record updated Sep 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4668 Issued in AK
Legal business name
NICK SARRIMANOLIS, M.D. LLC
Practice address
1867 Airport Way Ste 145B
Fairbanks, AK 99701-4055
Phone
(907) 451-1174
Fax
(907) 451-1173
NPI assigned
Dec 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2013

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

Authorized official

Name
Dr. Nick Sarrimanolis, M.D.
Title
Owner
Phone
(907) 451-1174

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 4668 AK Primary

Addresses

Primary practice location

1867 Airport Way Ste 145B
Fairbanks, AK 99701-4055

Mailing address

1867 Airport Way Ste 145B
Fairbanks, AK 99701-4055
Phone (907) 451-1174

Other identifiers 2

IdentifierTypeStateIssuer
4668OtherAKAK STATE LICENSE
MD42851MedicaidAK

National Provider Directory

National Provider Directory

Locations

1867 Airport Way
Ste 145B
Fairbanks, AK 99701
Phone (907) 451-1174

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1197244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379030400000",
    "number": "1760665012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1867 AIRPORT WAY STE 145B",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014055",
            "telephone_number": "907-451-1174",
            "fax_number": "907-451-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1867 AIRPORT WAY STE 145B",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014055",
            "telephone_number": "907-451-1174",
            "fax_number": "907-451-1173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICK SARRIMANOLIS, M.D. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-10",
        "last_updated": "2013-09-13",
        "status": "A",
        "authorized_official_last_name": "SARRIMANOLIS",
        "authorized_official_first_name": "NICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-451-1174",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "AK",
            "license": "4668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AK STATE LICENSE",
            "identifier": "4668",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD42851",
            "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 Sep 13, 2013; 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.