INTERIOR COMMUNITY HEALTH CENTER


Address: 1606 23rd Ave, Fairbanks, AK 99701-6407
Phone: 9074554567

INTERIOR COMMUNITY HEALTH CENTER (NPI# 1457552903) 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) 1457552903
Entity Type Organization
Organization Name INTERIOR COMMUNITY HEALTH CENTER
Practice Address 1606 23rd Ave
Fairbanks
AK 99701-6407
Practice Telephone 9074554567
Practice Fax Number 9074581589
Mailing Telephone 9074554567
Mailing Fax Number 9074581589
Enumeration Date 2007-05-31
Last Update Date 2008-08-04
Authorized Official Name CHERYL KILGORE (EXECUTIVE DIRECTOR)
Authorized Official Telephone 9074554567
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207Q00000X Family Medicine Allopathic & Osteopathic Physicians
Y 261QF0400X Clinic/Center
Specialization: Federally Qualified Health Center (FQHC)
Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
CLIA 02D0876889 01
AK CLIA 02D0902300 01

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1609942754 Interior Community Health Center Clinic/Center Usibelli Spur Rd, Tri Valley Community Center, Healy, AK 99743 2006-11-28
1588739015 Interior Community Health Center Clinic/Center 1606 23rd Ave, Fairbanks, AK 99701-6407 2006-11-21

Office Location

Street Address 1606 23RD AVE
City FAIRBANKS
State AK
Zip Code 99701-6407

Providers in the same location

NPI Name Taxonomy Address Enumeration
1952316630 June M Thomasson Family Medicine 1606 23rd Ave, Fairbanks, AK 99701-6407 2006-07-30
1235659004 Erin Dawn Stickels Physician Assistant 1606 23rd Ave, Fairbanks, AK 99701-6407 2017-06-22
1942558176 Caroline Cathleen Curtis Dentist 1606 23rd Ave, Fairbanks, AK 99701-6407 2012-08-20
1508168733 Kendel Lynn Bormann Physician Assistant 1606 23rd Ave, Fairbanks, AK 99701-6407 2010-11-19
1942514971 Erin Van Gundy Dentist 1606 23rd Ave, Fairbanks, AK 99701-6407 2010-08-02
1013155209 Sheila Diane Smith Social Worker 1606 23rd Ave, Fairbanks, AK 99701-6407 2009-01-27
1740430545 Moazzem Hossain Khan Internal Medicine 1606 23rd Ave, Fairbanks, AK 99701-6407 2008-09-29
1003062456 Jeffrey W Kilgore Dentist 1606 23rd Ave, Fairbanks, AK 99701-6407 2008-08-15
1841475159 Heather Ann Willis Dentist 1606 23rd Ave, Fairbanks, AK 99701-6407 2008-01-04
1700096294 Laboratory Corporation of America Clinical Medical Laboratory 1606 23rd Ave, Fairbanks, AK 99701-6407 2007-05-23
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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 261QF0400X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Federally Qualified Health Center (FQHC)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1821511064 Cross Road Health Ministries, Inc. Clinic/Center 187 Glenn Highway, Glennallen, AK 99588-0589 2017-07-19
1568902583 Sunshine Community Health Center, Inc Clinic/Center 42728 S Parks Highway, Talkeetna, AK 99676 2017-02-24
1467991455 Sunshine Community Health Center, Inc Clinic/Center 13930 E Timberwolf Loop, Talkeetna, AK 99676 2017-02-23
1477003978 Alaska Island Community Services Clinic/Center 110 Lynch Street, Wrangell, AK 99929 2016-10-07
1679718019 Camai Community Health Center, Inc. Clinic/Center # 2 School Rd, Naknek, AK 99633-0211 2008-12-15
1487818639 City of Galena Clinic/Center 74 Ruby Road, Ruby, AK 99768-0074 2008-07-17
1568626760 City of Galena Clinic/Center 30 Koyukuk Lane, Koyukuk, AK 99754-0030 2008-07-16
1669636866 City of Galena Clinic/Center 148 Katido Street, Kaltag, AK 99748-0148 2008-07-16
1952422859 Alaska Island Community Services Clinic/Center Naukati Community School, Naukati, AK 99950 2007-04-02
1699892307 Sunshine Community Health Center Inc Clinic/Center 24091 W Long Lake Rd, Willow, AK 99688-9999 2007-03-26
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Competitor

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City FAIRBANKS
Zip Code 99701

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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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