Individual provider Active NPI

Kristen M Sublett, CNM

  • Advanced Practice Midwife
  • Fairbanks, AK
National Provider Identifier
1821340142
Registry record updated Mar 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
Practice address
1717 W. Cowles St.
Fairbanks, AK 99701
Phone
(907) 451-6682
Fax
(907) 459-3976
NPI assigned
Oct 10, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X Primary

Addresses

Primary practice location

1717 W. Cowles St.
Fairbanks, AK 99701

Mailing address

1717 W. Cowles St.
Fairbanks, AK 99701
Phone (907) 451-6682

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130729000306 TX Practitioner - Certified Nurse Midwife (CNM) 1254572688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tanana Chiefs ConferenceGroup PAC ID 9537050109, 148 clinicians

Practice addresses (Care Compare)

1717 W Cowles St
Fairbanks, AK 99701-5926
Phone (907) 451-6682

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Tanana Chiefs Conference CurrentSince Apr 6, 2013 Accepting new patients
Tanana Chiefs Conference CurrentSince Apr 6, 2013 Accepting new patients
Fairbanks Memorial Hospital, LLC Past Accepting new patients

Locations

1650 Cowles St
Fairbanks, AK 99701
Phone (907) 452-8181

1717 W Cowles St
Fairbanks, AK 99701
Phone (907) 452-6682

Interoperability endpoints

  • Direct secure messaging: kristen.sublett.1@15989.direct.athenahealth.com

Organizations & group practices 3

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": "1349827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520812800000",
    "number": "1821340142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 W. COWLES ST.",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "99701",
            "telephone_number": "907-451-6682",
            "fax_number": "907-459-3976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 W. COWLES ST.",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "99701",
            "telephone_number": "907-451-6682",
            "fax_number": "907-459-3976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUBLETT",
        "first_name": "KRISTEN",
        "middle_name": "M",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-10",
        "last_updated": "2018-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

Verify at the official NPI Registry.