Active NPI
Tonya Lacole Fender, NNP
- Nurse Practitioner
- Anchorage, AK
National Provider Identifier
1770541724
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 1239
- Practice address
- 3200 Providence Dr
Anchorage, AK 99508-4615 - Phone
- (907) 212-5006
- Fax
- (907) 212-4896
- NPI assigned
- May 1, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 1239 | AK | Primary |
Addresses
Primary practice location
3200 Providence Dr
Anchorage, AK 99508-4615
Mailing address
PO Box 4105
Portland, OR 97208-4105
Phone (866) 907-1068
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1575349 | Medicaid | AK |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1239 | AK | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450656000000",
"number": "1770541724",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4105",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972084105",
"telephone_number": "866-907-1068",
"fax_number": "425-917-9141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3200 PROVIDENCE DR",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995084615",
"telephone_number": "907-212-5006",
"fax_number": "907-212-4896"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FENDER",
"first_name": "TONYA",
"middle_name": "LACOLE",
"credential": "NNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-01",
"last_updated": "2015-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "AK",
"license": "1239",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1575349",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Anchorage, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.