Individual provider Active NPI

Sarah Elizabeth Evans, APRN, NP

  • Pediatric Nurse Practitioner
  • Fairbanks, AK
National Provider Identifier
1790453140
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
179526 Issued in AK
Practice address
3550 Airport Way Ste 4
Fairbanks, AK 99709-4772
Phone
(907) 479-2331
NPI assigned
Sep 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 179526 AK Primary

Addresses

Primary practice location

3550 Airport Way Ste 4
Fairbanks, AK 99709-4772

Mailing address

5240 Hardland Ave
Fairbanks, AK 99709-4529
Phone (520) 784-3463

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211005003051 AK Practitioner - Nurse Practitioner 2466850466 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alpine Medical Group LLC Pediatrics CurrentSince Sep 1, 2022 Accepting new patients

Locations

2054 30th Ave
Fairbanks, AK 99701
Phone (907) 455-4555

605 Chief Thomas Dr
Fairbanks, AK 99709
Phone (907) 455-4555

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1630454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1790453140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5240 HARDLAND AVE",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997094529",
            "telephone_number": "520-784-3463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 AIRPORT WAY STE 4",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997094772",
            "telephone_number": "907-479-2331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "SARAH",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "APRN, NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-01",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AK",
            "license": "179526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

Verify at the official NPI Registry.