Individual provider Active NPI

Nicole Elizabeth Sharpe

  • Registered Nurse
  • Fairbanks, AK
National Provider Identifier
1790468155
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95258013 Issued in CA
Practice address
815 2ND Ave
Fairbanks, AK 99701-4400
Phone
(907) 374-0852
NPI assigned
Aug 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95258013 CA Primary

Addresses

Primary practice location

815 2ND Ave
Fairbanks, AK 99701-4400

Mailing address

1107 Neon Forest Cir Apt 2
Longmont, CO 80504-7032
Phone (303) 562-8251

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
I20250417003254 AK Practitioner - Nurse Practitioner 2264957661 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nurses Diversified Systems IncGroup PAC ID 7517127996, 5 clinicians

Practice addresses (Care Compare)

815 2ND Ave
Suite 122
Fairbanks, AK 99701-4469
Phone (907) 750-8114

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95258013CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Nurses Diversified Systems, Inc CurrentSince Feb 6, 2025 Accepting new patients
Nurses Diversified Systems, Inc CurrentSince Feb 6, 2025 Accepting new patients

Locations

815 2nd Ave
Ste 122
Fairbanks, AK 99701
Phone (907) 328-9664

815 2nd Ave
Ste 204
Fairbanks, AK 99701
Phone (907) 750-8114

Interoperability endpoints

  • Direct secure messaging: ndsystemsinc.nicolesharpe@144017.advancedmd-direct.com

Organizations & group practices 2

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": "1691625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1790468155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 NEON FOREST CIR APT 2",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805047032",
            "telephone_number": "303-562-8251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 2ND AVE",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014400",
            "telephone_number": "907-374-0852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARPE",
        "first_name": "NICOLE",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-10",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95258013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

Verify at the official NPI Registry.