Individual provider Active NPI

Kerry Phillip Wappett, M.D.

  • Obstetrics & Gynecology Physician
  • Fairbanks, AK
National Provider Identifier
1982846267
Registry record updated Dec 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
7693 Issued in AK
Practice address
1001 Noble St
Fairbanks, AK 99701-4922
Phone
(907) 459-3500
Fax
(907) 459-3542
NPI assigned
Apr 1, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Obstetrics & Gynecology Physician 207V00000X 7693 AK Primary

Addresses

Primary practice location

1001 Noble St
Fairbanks, AK 99701-4922

Mailing address

1001 Noble St
Fairbanks, AK 99701-4922
Phone (907) 459-3500

Other identifiers 1

IdentifierTypeStateIssuer
1583474MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130806000671 AK Practitioner - Obstetrics/Gynecology 1254573108 Reassigns benefits to 1 organization
I20221201002492 TX Practitioner - Obstetrics/Gynecology 1254573108 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Medical College of Wisconsin, 2009
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

Hospital & facility affiliations

  • Fairbanks Memorial Hospital Hospital, Fairbanks, AK, CCN 020012

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
7693AKMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tanana Chiefs Conference CurrentSince Sep 22, 2022 Accepting new patients
Tanana Valley Clinic LLC CurrentSince Jan 1, 2017 Accepting new patients
Tanana Chiefs Conference CurrentSince Sep 22, 2022 Accepting new patients
Tanana Valley Clinic LLC CurrentSince Jan 1, 2017 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

1001 Noble St
Fairbanks, AK 99701
Phone (907) 276-2806

Interoperability endpoints

  • Direct secure messaging: kerry.wappett@foundationhealth.cernerdirect.com
  • Direct secure messaging: kerry.wappett.1@15989.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1238544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481500800000",
    "number": "1982846267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 NOBLE ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014922",
            "telephone_number": "907-459-3500",
            "fax_number": "907-459-3542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 NOBLE ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014922",
            "telephone_number": "907-459-3500",
            "fax_number": "907-459-3542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAPPETT",
        "first_name": "KERRY",
        "middle_name": "PHILLIP",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-01",
        "last_updated": "2016-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AK",
            "license": "7693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1583474",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

Verify at the official NPI Registry.