NPIMap

Organization Active NPI

Fairweather LLC

  • Physician Assistant
  • Anchorage, AK
National Provider Identifier
1972842433
Registry record updated Dec 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
940479 Issued in AK
Legal business name
FAIRWEATHER LLC
Practice address
9525 King St
Anchorage, AK 99515-1817
Phone
(907) 346-3247
Fax
(907) 349-1920
NPI assigned
Feb 4, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2013

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

Authorized official

Name
Ms. Amy Renee Bolam
Title
Practice Manager
Phone
(907) 248-8008

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X 940479 AK Primary

Addresses

Primary practice location

9525 King St
Anchorage, AK 99515-1817

Mailing address

7999 Jewel Lake Rd
Anchorage, AK 99502-4251
Phone (907) 331-3620

National Provider Directory

National Provider Directory
Tax ID family
Fairweather LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1359936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387497600000",
    "number": "1972842433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7999 JEWEL LAKE RD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995024251",
            "telephone_number": "907-331-3620",
            "fax_number": "907-644-4477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9525 KING ST",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995151817",
            "telephone_number": "907-346-3247",
            "fax_number": "907-349-1920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRWEATHER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-04",
        "last_updated": "2013-12-20",
        "status": "A",
        "authorized_official_last_name": "BOLAM",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "907-248-8008",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "940479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2013; 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.