Active NPI
E Leanne Converse, M.D.
- Family Medicine Physician
- Haines, AK
National Provider Identifier
1790916765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- AA1435
- Practice address
- 131 1St Avenue South
Haines, AK 99827 - Phone
- (907) 766-6300
- NPI assigned
- Aug 7, 2009
- Last updated
- Aug 7, 2009
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | AA1435 | AK | Primary |
Addresses
Primary practice location
131 1St Avenue South
Haines, AK 99827
Mailing address
PO Box 1549
Haines, AK 99827-1549
Phone (907) 766-6300
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AA1435 | AK | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairbanks Clinic Inc | Family Medicine | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1249603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1249603200000",
"number": "1790916765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1549",
"city": "HAINES",
"state": "AK",
"postal_code": "998271549",
"telephone_number": "907-766-6300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "131 1ST AVENUE SOUTH",
"city": "HAINES",
"state": "AK",
"postal_code": "99827",
"telephone_number": "907-766-6300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONVERSE",
"first_name": "E",
"middle_name": "LEANNE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-07",
"last_updated": "2009-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AK",
"license": "AA1435",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Haines, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.