NPIMap

Organization Active NPI

Fairbanks Surgery, LLC

  • Surgery Physician
  • Fairbanks, AK
National Provider Identifier
1790017291
Registry record updated Dec 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD1335 Issued in AK
Legal business name
FAIRBANKS SURGERY, LLC
Practice address
1919 Lathrop St Ste 204
Fairbanks, AK 99701-5942
Phone
(907) 452-8151
NPI assigned
Feb 8, 2010
Last updated
Dec 17, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2010

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

Authorized official

Name
William H Montano, MDNPI 1447228606
Title
Officer
Phone
(907) 452-8151

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD1335 AK Primary
Vascular Surgery Physician 2086S0129X MD1335 AK
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD1335 AK

Addresses

Primary practice location

1919 Lathrop St Ste 204
Fairbanks, AK 99701-5942

Mailing address

1919 Lathrop St Ste 204
Fairbanks, AK 99701-5942
Phone (907) 452-8151

National Provider Directory

National Provider Directory

Locations

1919 Lathrop St
Ste 204
Fairbanks, AK 99701
Phone (907) 452-8151

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1265587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292544000000",
    "number": "1790017291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 LATHROP ST STE 204",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997015942",
            "telephone_number": "907-452-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 LATHROP ST STE 204",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997015942",
            "telephone_number": "907-452-8151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRBANKS SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-08",
        "last_updated": "2010-12-17",
        "status": "A",
        "authorized_official_last_name": "MONTANO",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "907-452-8151",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AK",
            "license": "MD1335",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "AK",
            "license": "MD1335",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "AK",
            "license": "MD1335",
            "primary": false
        }
    ],
    "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 Dec 17, 2010; 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.