SEAN MICHAEL TIMMONS (NPI# 1497956338) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497956338 |
| Entity Type | Individual |
| Full Name | SEAN MICHAEL TIMMONS |
| Credential | PA-C |
| Practice Address |
1919 Lathrop St Fairbanks AK 99701-5937 |
| Practice Telephone | 9074575277 |
| Practice Fax Number | 9074575278 |
| Mailing Telephone | 9074575277 |
| Mailing Fax Number | 9074575278 |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2009-11-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
769 | AK | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DEA | MT1589235 | 01 | |
| AK | MEDICARE RAILROAD | P00396941 | 01 |
| AK | MDA0059 | 05 |
| Street Address |
1919 LATHROP ST |
| City | FAIRBANKS |
| State | AK |
| Zip Code | 99701-5937 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699774299 | Letha C Archer | Pediatrics | 1919 Lathrop St, Suite 100, Fairbanks, AK 99701-5937 | 2005-07-18 |
| 1245708668 | Tanana Valley Clinic LLC | Clinic/Center | 1919 Lathrop St, Fairbanks, AK 99701-5937 | 2018-11-03 |
| 1275084626 | Jeffrey W. Kilgore Dmd PC | Dentist | 1919 Lathrop St, Ste: 211, Fairbanks, AK 99701-5937 | 2016-10-20 |
| 1992256341 | Otter Dental | Dentist | 1919 Lathrop St, Suite 211, Fairbanks, AK 99701-5937 | 2016-10-20 |
| 1467909218 | Rebecca Rengel | Physical Therapist | 1919 Lathrop St, Ste 123, Fairbanks, AK 99701-5937 | 2016-09-08 |
| 1538613203 | Brent Little | Physical Therapist | 1919 Lathrop St, Suite 123, Fairbanks, AK 99701-5937 | 2016-08-10 |
| 1396298626 | Nicholas Nzioka Ndetti Jr. | Pharmacist | 1919 Lathrop St, Suite 109, Fairbanks, AK 99701-5937 | 2016-08-03 |
| 1366829699 | Karolina Priebe | Nurse Practitioner | 1919 Lathrop St, Suite 101, Fairbanks, AK 99701-5937 | 2015-05-06 |
| 1124405618 | David Boyd | Specialist/Technologist | 1919 Lathrop St, Suite 123, Fairbanks, AK 99701-5937 | 2015-05-04 |
| 1679903140 | Heidi Wood | Physical Therapist | 1919 Lathrop St, #123, Fairbanks, AK 99701-5937 | 2013-11-20 |
| 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 | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801314596 | Sara Breann Langford | Physician Assistant | 575 Riverstone Way Unit 1, Fairbanks, AK 99709-2939 | 2017-09-01 |
| 1033451703 | Allison Cooper | Physician Assistant | 2310 Peger Rd Suite 105, Fairbanks, AK 99709-4848 | 2013-03-20 |
| 1487928784 | Michael Jon Voorhees | Physician Assistant | 1717 Cowles Street, Fairbanks, AK 99701 | 2012-03-05 |
| 1487926218 | Steven Lee Craddick | Physician Assistant | 1867 Airport Frontage Road, Suite B (u.s. Healthworks Alaska), Fairbanks, AK 99701-1867 | 2012-02-09 |
| 1245491125 | Bridget Anne Johnson | Physician Assistant | 3875 Geist Rd, Suite E381, Fairbanks, AK 99709-3549 | 2008-06-23 |
| 1720092067 | Sylvia Ann Mccormick | Physician Assistant | 1008 16th Ave Ste 100, Fairbanks, AK 99701-6078 | 2006-07-29 |
| 1982627667 | Lindsay Leland Roberts | Physician Assistant | 2166 Yellow Leaf Ct, Fairbanks, AK 99709-6278 | 2006-07-25 |
| 1427078161 | Judy Lynn Lowe | Physician Assistant | 1867 Airport Way Ste 130b, Fairbanks, AK 99701-4056 | 2006-07-19 |
| 1689625964 | Van E Lamore | Physician Assistant | 3745 Geist Rd, Fairbanks, AK 99709-3554 | 2006-05-12 |
| 1023091618 | Caryn Scott | Physician Assistant | 201 1st Ave, Suite 200, Fairbanks, AK 99701-4848 | 2005-11-28 |
| 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.