ROY FUKUOKA (NPI# 1629067590) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629067590 |
| Entity Type | Individual |
| Full Name | ROY FUKUOKA |
| Practice Address |
2500 S Woodworth Loop Palmer AK 99645-8984 |
| Mailing Address |
8737 Inyo Cir Eagle River AK 99577-9402 |
| Practice Telephone | 9072270162 |
| Mailing Telephone | 9072270162 |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2010-10-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 281 | AK | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2500 S WOODWORTH LOOP |
| City | PALMER |
| State | AK |
| Zip Code | 99645-8984 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720603939 | Robert A Grogan | Pharmacist | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2020-06-12 |
| 1184258170 | Michelle Hailey Allen | Registered Nurse | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2020-02-27 |
| 1528615424 | Tara E Bonardi | Nurse Anesthetist, Certified Registered | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2019-08-25 |
| 1619532215 | Eric Atkinson | Registered Nurse | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2019-05-08 |
| 1588133748 | Erin Alaina Reding | Nurse Practitioner | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2018-11-17 |
| 1043722929 | Fireweed Surgical Assists LLC | Nurse Practitioner | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2017-10-31 |
| 1740713866 | Annette Kasprzak | Emergency Medicine | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2017-04-05 |
| 1669858106 | Jesse Atwood Md Pediatrics, LLC | Pediatrics | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2015-08-06 |
| 1881080018 | Kili Grace O'bryant | Emergency Medicine | 2500 S Woodworth Loop, Palmer, AK 99645 | 2015-04-14 |
| 1205229341 | Meghan Barnett Sonnabend | Physician Assistant | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2015-03-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295357135 | Kasey M Flintoft | Occupational Therapist | 7200 E. Jim Cottrell Cir, Palmer, AK 99645 | 2020-05-14 |
| 1629601471 | Courtney Randol | Licensed Practical Nurse | 14405 E Pace Dr., Palmer, AK 99645 | 2020-02-20 |
| 1689213092 | Valerie Anne Delaune | Acupuncturist | 9693 N. Little Otter Dr., Palmer, AK 99645 | 2020-01-02 |
| 1003464512 | Alaskan Sunrise Behavioral Health, L.L.C. | Clinic/Center | 14460 E. Pace Dr., Palmer, AK 99645 | 2019-08-28 |
| 1548814718 | Maple Springs of Palmer Snf Holdings, LLC | Skilled Nursing Facility | 12130 E Maple Springs Way, Palmer, AK 99645 | 2019-07-26 |
| 1952868655 | Carla Beth Kelly | Physical Therapist | 7200 Jim Cottrell Circle, Palmer, AK 99645 | 2019-02-28 |
| 1366938375 | Wendy S Page | Behavior Technician | 7200 E Jim Cottrell, Wasilla, AK 99645 | 2018-07-03 |
| 1154845170 | Sarah Elizabeth Gilliland | Occupational Therapist | 7200 E Jim Cottrell Circle, Palmer, AK 99645 | 2017-08-01 |
| 1558885137 | Garland Brooks | Massage Therapist | 1934 Prospect Dr, Palmer, AK 99645 | 2017-07-26 |
| 1386165009 | Sommer Dawn Nielsen | Massage Therapist | 3566 N Mars Ave., Palmer, AK 99645 | 2017-07-03 |
| Find all providers in zip 99645 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528615424 | Tara E Bonardi | Nurse Anesthetist, Certified Registered | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2019-08-25 |
| 1982950978 | Chester Joseph Witczak | Nurse Anesthetist, Certified Registered | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2012-07-27 |
| 1215265400 | Kirk Jason Nash | Nurse Anesthetist, Certified Registered | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2009-11-25 |
| 1518987015 | Jennifer Kay Lent | Nurse Anesthetist, Certified Registered | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2006-07-20 |
| 1992781389 | Judy L Ward | Nurse Anesthetist, Certified Registered | 2500 S Woodworth Loop, Palmer, AK 99645-8984 | 2005-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578103362 | Jennifer Lichtenberg | Nurse Anesthetist, Certified Registered | 8000 Little Dipper Ave Unit A, Anchorage, AK 99504-4127 | 2020-01-09 |
| 1861032914 | Kenai Anesthesia Associates, LLC | Nurse Anesthetist, Certified Registered | 100 Trading Bay Rd Ste 9, Kenai, AK 99611-7786 | 2020-01-07 |
| 1558840306 | Birch Mountain Anesthesia Consultants LLC | Nurse Anesthetist, Certified Registered | 114 Minnie St Ste D, Fairbanks, AK 99701-3000 | 2018-08-13 |
| 1043606668 | Alicia Marie Ferguson | Nurse Anesthetist, Certified Registered | 611 Clipper Ship Ct, Anchorage, AK 99515-3623 | 2015-04-09 |
| 1437585833 | Anesthesia Relief Staffing LLC | Nurse Anesthetist, Certified Registered | 235 E 8th Ave, Suite 3a, Anchorage, AK 99501-3615 | 2013-09-18 |
| 1093060170 | Jeremy R Taysom | Nurse Anesthetist, Certified Registered | 2910 E Tamarak Ave, Wasilla, AK 99654-7484 | 2012-07-16 |
| 1235450222 | Adam Christopher Faltersack | Nurse Anesthetist, Certified Registered | 673d Medical Group, 5955 Zeamer Ave, Jber, AK 99506 | 2010-06-14 |
| 1851539670 | Adam H Dalgleish | Nurse Anesthetist, Certified Registered | 3rd Mdg, 5955 Zeamer Avenue, Elmendorf Afb, AK 99506 | 2009-02-02 |
| 1285704155 | Cheri Kay Hutchins | Nurse Anesthetist, Certified Registered | 700 Eddie Hoffman Drive, Bethel, AK 99559 | 2006-11-08 |
| 1457420523 | Christina A Logan | Nurse Anesthetist, Certified Registered | 2303 Tulik Dr, Anchorage, AK 99517-1132 | 2006-11-06 |
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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.