Individual provider Active NPI

Diane R Thompson

  • Community Health Worker
  • Fairbanks, AK
National Provider Identifier
1912630864
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
122 1St Ave Ste 6001221
Fairbanks, AK 99701-4871
Phone
(907) 452-8251
NPI assigned
Jul 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Student in an Organized Health Care Education/Training Program 390200000X
Community Health Worker 172V00000X AK Primary

Addresses

Primary practice location

122 1St Ave Ste 6001221
Fairbanks, AK 99701-4871

Mailing address

122 1St Ave Ste 6001221
Fairbanks, AK 99701-4871
Phone (907) 452-8251

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

NPI Registry JSON

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

{
    "created_epoch": "1657152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1912630864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 1ST AVE STE 6001221",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014871",
            "telephone_number": "907-452-8251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 1ST AVE STE 6001221",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014871",
            "telephone_number": "907-452-8251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "DIANE",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-07",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "AK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; 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.