CHIEF ANDREW ISSAC HEALTH CENTER (NPI# 1083258677) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083258677 |
| Entity Type | Organization |
| Organization Name | CHIEF ANDREW ISSAC HEALTH CENTER |
| Practice Address |
1717 W Cowles St Fairbanks AK 99701-5926 |
| Mailing Address |
122 1st Ave Ste 106 Fairbanks AK 99701-4871 |
| Practice Telephone | 9074516682 |
| Mailing Telephone | 9074528251 |
| Enumeration Date | 2019-11-06 |
| Last Update Date | 2019-11-06 |
| Authorized Official Name | JACOLINE BERGSTROM (EX. DIRECTOR OF H.S.) |
| Authorized Official Telephone | 9074528251 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427236793 | Chief Andrew Issac Health Center | Clinic/Center | 1408 19th Ave, Fairbanks, AK 99701-5903 | 2008-02-08 |
| Street Address |
1717 W COWLES ST |
| City | FAIRBANKS |
| State | AK |
| Zip Code | 99701-5926 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942299144 | Laura Catalano | Physician Assistant | 1717 W Cowles St, Fairbanks, AK 99701 | 2005-10-19 |
| 1215554605 | Reilly Jorgensen | Registered Nurse | 1717 W Cowles St, Fairbanks, AK 99701-5926 | 2020-07-01 |
| 1154947109 | Jan Rud | Registered Nurse | 1717 W Cowles St, Fairbanks, AK 99701-5926 | 2020-06-24 |
| 1295356673 | Cheyanne Esmailka | Community Health Worker | 1717 W Cowles St, Fairbanks, AK 99701-5926 | 2020-04-27 |
| 1699395111 | Jordyn Lillie | Community Health Worker | 1717 W Cowles St, Fairbanks, AK 99701-5926 | 2020-04-24 |
| 1932738135 | Kaneisha Radgosky | Registered Nurse | 1717 W Cowles St, Fairbanks, AK 99701-5926 | 2020-04-08 |
| 1376172585 | Lucinda Dowdy | Licensed Practical Nurse | 1717 W Cowles St, Fairbanks, AK 99701-5926 | 2020-04-08 |
| 1225662554 | Jennifer Landis | Registered Nurse | 1717 W Cowles St, Fairbanks, AK 99701-5926 | 2020-02-25 |
| 1427681329 | Bozena Glover | Registered Nurse | 1717 W Cowles St, Fairbanks, AK 99701-5926 | 2020-02-19 |
| 1326678699 | Samantha Arbuckle | Registered Nurse | 1717 W Cowles St, Fairbanks, AK 99701-5926 | 2020-01-24 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 99701 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447895578 | Tanana Chiefs Conference | Community/Behavioral Health | 117 1st Ave, Fairbanks, AK 99701-4802 | 2019-11-13 |
| 1497390538 | Tanana Chiefs Conference | Community/Behavioral Health | 122 1st Ave Ste 106, Fairbanks, AK 99701-4871 | 2019-11-13 |
| 1336614205 | Extended Family Alaska LLC | Community/Behavioral Health | 978 Pickering Dr, Fairbanks, AK 99709-5770 | 2018-10-08 |
| 1316247091 | North Star Council On Aging, Inc. | Community/Behavioral Health | 1424 Moore St, Fairbanks, AK 99701-5716 | 2010-10-27 |
| 1881713261 | Interior Aids Association | Community/Behavioral Health | 710 3rd Ave, Fairbanks, AK 99701-4455 | 2007-03-28 |
| 1912079088 | Fairbanks Resource Agency Inc | Community/Behavioral Health | 805 Airport Road, Fairbanks, AK 99701 | 2006-11-14 |
| 1841835980 | Tanana Chiefs Conference | Community/Behavioral Health | 1521 S Cushman St, Fairbanks, AK 99701-6203 | 2019-11-13 |
| 1306481437 | Tanana Chiefs Conference | Community/Behavioral Health | 1717 W Cowles St, Fairbanks, AK 99701-5926 | 2019-11-13 |
| 1053955674 | Tanana Chiefs Confenerce | Community/Behavioral Health | 1300 Moore St, Fairbanks, AK 99701-5761 | 2019-11-06 |
| 1053952960 | Gavin Hage | Community/Behavioral Health | 3101 Lathrop St, Fairbanks, AK 99701-7426 | 2019-10-02 |
| Find all providers in FAIRBANKS | ||||
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| 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.