TANANA VALLEY CLINIC LLC


Address: 1405 Kellum St, Fairbanks, AK 99701-4189
Phone: 9074593500

TANANA VALLEY CLINIC LLC (NPI# 1073081287) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1073081287
Entity Type Organization
Organization Name TANANA VALLEY CLINIC LLC
Practice Address 1405 Kellum St
Fairbanks
AK 99701-4189
Mailing Address Po Box 73720
Fairbanks
AK 99707-3720
Practice Telephone 9074593500
Mailing Telephone 9074593500
Mailing Fax Number 9074593526
Enumeration Date 2018-11-06
Last Update Date 2018-11-06
Authorized Official Name STEPHEN PAUL LESLIE (CFO)
Authorized Official Telephone 9074583310
Is Organization Subpart Y
Parent Organization Name FOUNDATION HEALTH LLC

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM1300X Clinic/Center
Specialization: Multi-Specialty
Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
AK 1656193 05

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1063980118 Tanana Valley Clinic LLC Clinic/Center 1101 Noble St, Fairbanks, AK 99701-4924 2018-11-07
1073081485 Tanana Valley Clinic LLC Clinic/Center 570 Riverstone Way, Fairbanks, AK 99709-2940 2018-11-05
1245708668 Tanana Valley Clinic LLC Clinic/Center 1919 Lathrop St, Fairbanks, AK 99701-5937 2018-11-03
1922559558 Tanana Valley Clinic LLC Clinic/Center 1001 Noble St, Fairbanks, AK 99701-4948 2016-10-19

Office Location

Street Address 1405 KELLUM ST
City FAIRBANKS
State AK
Zip Code 99701-4189

Providers in the same location

NPI Name Taxonomy Address Enumeration
1720052137 Joni Simpson Counselor 1405 Kellum St, Fairbanks, AK 99701-4102 2006-02-14
1689920142 Alchemy Orthotics and Prosthetics Prosthetic/Orthotic Supplier 1405 Kellum St, Suite 201, Fairbanks, AK 99701-4189 2012-08-01
1669619599 Steese Orthopaedic Associates, LLC Orthopaedic Surgery 1405 Kellum St, Suite 101, Fairbanks, AK 99701-4102 2009-01-14
1558498402 Ralph Sylvan Dixon Podiatrist 1405 Kellum St, Suite 200, Fairbanks, AK 99701-4189 2007-02-27
1922073188 Michael Pomeroy Physician Assistant 1405 Kellum St, Suite 101, Fairbanks, AK 99701-4189 2006-02-21
1356316699 Donald Ives Family Medicine 1405 Kellum St, Suite 300, Fairbanks, AK 99701-4189 2006-02-21

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1659984987 Resource Center for Parents & Children, Inc. Social Worker 726 26th Ave, Suite #2, Fairbanks, AK 99701 2020-08-26
1134738982 Aaron Paul Sarauer Behavior Technician 3121 Lathrop St., Fairbanks, AK 99701 2020-07-28
1437715505 Fabienne Rose Marie Siddall Case Manager/Care Coordinator 122 1st Avenue, Fairbanks, AK 99701 2019-05-14
1902461957 Jacqueline Marie Rahm Counselor Family Centered Services of Alaska - Rtc, 3101 Lathrop St., Fairbanks, AK 99701 2019-05-06
1821588989 Corrie Wilson Nurse Practitioner 1025 Barnette Street, Fairbanks, AK 99701 2018-05-15
1922519305 Sarishma Sangeeta Lal Registered Nurse 815 2nd Ave Ste 122, Fairbanks, AK 99701 2017-10-12
1245690569 Christine L Simko Naturopath 1275 Sadler Way, Ste 100 Rm 147, Fairbanks, AK 99701 2016-02-29
1932581600 Jennifer Davis Registered Nurse 1025 West Barnette St., Fairbanks, AK 99701 2015-06-18
1700272705 John D. Zipperer Jr Md, LLC Clinic/Center 751 Old Richardson Hwy., Fairbanks, AK 99701 2015-04-07
1578957460 Mara Justine Becker Physician Assistant 1717 W. Cowles St, Fairbanks, AK- ALASKA 99701 2015-03-27
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Taxonomy Information

Taxonomy Code 261QM1300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Multi-Specialty

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1063980118 Tanana Valley Clinic LLC Clinic/Center 1101 Noble St, Fairbanks, AK 99701-4924 2018-11-07
1942751631 Fairbanks Memorial Cardiology Clinic, LLC Clinic/Center 1650 Cowles St Dept 61a, Fairbanks, AK 99701-5907 2016-10-18
1073081485 Tanana Valley Clinic LLC Clinic/Center 570 Riverstone Way, Fairbanks, AK 99709-2940 2018-11-05
1245708668 Tanana Valley Clinic LLC Clinic/Center 1919 Lathrop St, Fairbanks, AK 99701-5937 2018-11-03
1922559558 Tanana Valley Clinic LLC Clinic/Center 1001 Noble St, Fairbanks, AK 99701-4948 2016-10-19
1770933871 Arctic Pain Relief Center, LLC Clinic/Center 1901 Airport Way Ste 102, Fairbanks, AK 99701-4049 2016-06-20
1962803908 Banner Health Physicians Alaska LLC Clinic/Center 1001 Noble St, Fairbanks, AK 99701-4948 2014-09-09
1225273667 Margaret M Wilson Clinic/Center 1408 19th Ave., Chief Andrew Isaac Health Clinic, Fairbanks, AK 99701 2008-12-15
1386763290 Fairbanks Memorial Physician Specialities Clinic/Center 1650 Cowles St, Fairbanks, AK 99701-5925 2007-03-29

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1487265690 Whole Family Integrated Wellness LLC Clinic/Center 600 E 36th Ave Ste 300, Anchorage, AK 99503-4168 2020-08-11
1528600947 Southcentral Foundation Clinic/Center 6901 E Tudor Rd Ste 8, Anchorage, AK 99507-1254 2019-10-17
1558899807 Arctic Chiropractic and Physical Medicine Kodiak Clinic/Center 2975 Mill Bay Rd Ste A, Kodiak, AK 99615-7831 2017-05-31
1811420391 Southcentral Foundation Clinic/Center 1021 E 3rd Ave, Anchorage, AK 99501-6102 2017-04-11
1689021776 Southcentral Foundation Clinic/Center 755 A St, Anchorage, AK 99501-3625 2016-05-18
1194152058 Peninsula Pediatric Therapy, Inc. Clinic/Center 7335 Palmer Wasilla Hwy, Palmer, AK 99645-6007 2013-10-08
1154591451 La Integrative Primary Care Centre Inc Clinic/Center 8811 Toloff St, Anchorage, AK 99507-3848 2008-03-03
1962572099 Juneau Family Birth Center Clinic/Center 3225 Hospital Dr Unit 106, Juneau, AK 99801-7863 2006-11-08
1912954272 Southcentral Foundation Clinic/Center 101 Airport Road, Iliamna, AK 99606 2006-05-30
1063467223 Southcentral Foundation Clinic/Center 10 Dnr Road, Mcgrath, AK 99627 2006-05-24
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Competitor

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City FAIRBANKS
Zip Code 99701

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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