Shan Jiang, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

5387 Issued in AK

Practice address

1650 Cowles St
Fairbanks, AK 99701-5925

Phone

(800) 945-9877

Fax

(801) 733-5618

NPI assigned

Jul 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Fairbanks Pain Consulting, LLC

  • Pain Clinic/Center
  • Fairbanks, AK
  • NPI 1932436672
  Authorized official Same address or phone
• Fairbanks Anesthesia Inc.

  • Anesthesiology Physician
  • Fairbanks, AK
  • NPI 1629098140
  NPD (past)

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861415622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 DAVIS RD APT C7",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997095270",
            "telephone_number": "907-460-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COWLES ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997015925",
            "telephone_number": "800-945-9877",
            "fax_number": "801-733-5618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIANG",
        "first_name": "SHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AK",
            "license": "5387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD2985",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valerie Jensen, LCSW
• Nam Wook Jeon, L. AC
• Jerome D. Jackson (Medical Center Pharmacy)
• Matthew Jeselnik
• Leona Lynn Jewell
• Amber Jimmie
• Andrean Joyce Jimmie
• Dewayne Gene Jimmie
• Job Ready, Inc. (Ready Care)
• Job Ready, Inc. (Ready Care)

• Anesthesiology Physician in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Anesthesiology Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.