Banner Health Physicians Alaska LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

BANNER HEALTH PHYSICIANS ALASKA LLC

Practice address

1001 Noble St
Fairbanks, AK 99701-4948

Phone

(907) 459-3507

Fax

(907) 459-3532

NPI assigned

Sep 9, 2014

Organization subpart

Yes

Parent organization

BANNER MEDICAL GROUPAs reported in NPPES

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

Authorized official

Name

Dennis Dahlen

Title

Sr VP Finance

Phone

(602) 747-4000

Specialties & licenses 1

Addresses

Part of

Tiffany Weathers

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Banner Health

  • Critical Access Hospital
  • Payson, AZ
  • NPI 1063923340

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1410220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410393600000",
    "number": "1962803908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 N 12TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062837",
            "telephone_number": "602-747-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 NOBLE ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014948",
            "telephone_number": "907-459-3507",
            "fax_number": "907-459-3532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNER HEALTH PHYSICIANS ALASKA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BANNER MEDICAL GROUP",
        "enumeration_date": "2014-09-09",
        "last_updated": "2014-09-11",
        "status": "A",
        "authorized_official_last_name": "DAHLEN",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "SR VP FINANCE",
        "authorized_official_telephone_number": "602-747-4000"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosa Ballard, LPN
• Tawanda Betty Ballard
• Melissa J Balvanz, OTR/L
• Flor M Banks, LMT, CMT
• Banner Health
• Banner Home Care-Arizona
• Banner Home Medical Equipment
• Barbara L. Wilson, LCSW, PC
• Christan Toini Barber, LMT
• Laura Gabriela Barbosa

• Multi-Specialty Clinic/Center in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Multi-Specialty Clinic/Center in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2014; 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.