MCKINLEY ORTHOPEDIC AND SPORTS MEDICINE, LLC (NPI# 1760938021) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760938021 |
| Entity Type | Organization |
| Organization Name | MCKINLEY ORTHOPEDIC AND SPORTS MEDICINE, LLC |
| Practice Address |
3745 Geist Road Fairbanks AK 99709-3554 |
| Practice Telephone | 9074563341 |
| Practice Fax Number | 9074563443 |
| Mailing Telephone | 9074563341 |
| Mailing Fax Number | 9074563443 |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2016-08-28 |
| Authorized Official Name | JENELLE M MORRIS (ADMINISTRATION CLERK) |
| Authorized Official Telephone | 9074563341 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | MEDO7651 | AK | Allopathic & Osteopathic Physicians |
| Y | 207X00000X | Orthopaedic Surgery | 5762 | AK | Allopathic & Osteopathic Physicians |
| Street Address |
3745 GEIST ROAD |
| City | FAIRBANKS |
| State | AK |
| Zip Code | 99709-3554 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053341594 | Daniel R Johnson | Orthopaedic Surgery | 3745 Geist Road, Fairbanks, AK 99709-3554 | 2006-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255946810 | Beacon Monitoring Professional Services | Technician, Other | 745 Staffordshire Rd, Fairbanks, AK 99709 | 2020-09-10 |
| 1235629544 | Fairbanks Healing Space | Health Educator | 3875 Geist Road, Suite E #136, Fairbanks, AK 99709 | 2018-05-11 |
| 1609395409 | Shawn K Goggins | Counselor | 1423 Peger Road, Fairbanks, AK 99709 | 2017-09-12 |
| 1710433347 | Jay Titus | Technician/Technologist | 2884 Marina Drive, Fairbanks, AK 99709 | 2016-09-01 |
| 1710391610 | Hannah Summerfelt | Dentist | 3539 Thomas St, Fairbanks, AK 99709 | 2014-06-18 |
| 1629407325 | Diane Louise Mitchell | Nurse Practitioner | 4650 Harvard Cir, Fairbanks, AK 99709 | 2013-11-04 |
| 1407147929 | Christina Martz | Counselor | 1270 Summet Drive, Fairbanks, AK 99709 | 2011-05-02 |
| 1255652285 | Surgery Center of Fairbanks LLC | Clinic/Center | 2310 Peger Road, Fairbanks, AK 99709 | 2010-06-14 |
| 1962661835 | John Leo Hughes Jr Jr. | Dentist | 3437 Airport Way, Suite 205, Fairbanks, AL 99709 | 2008-06-05 |
| 1508042417 | Katherine E Johnson, Md PC | Ophthalmology | 2485 Chief William Drive, Suite 100, Fairbanks, AK 99709 | 2008-01-10 |
| Find all providers in zip 99709 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053341594 | Daniel R Johnson | Orthopaedic Surgery | 3745 Geist Road, Fairbanks, AK 99709-3554 | 2006-07-03 |
| 1356307458 | Mark Alan Wade | Orthopaedic Surgery | 2310 Peger Rd, Ste 105, Fairbanks, AK 99709-5315 | 2006-04-26 |
| 1821516345 | Benjamin Douglas Johnson | Orthopaedic Surgery | 3745 Geist Rd, Fairbanks, AK 99709-3554 | 2017-09-05 |
| 1295175651 | Neal Everson | Orthopaedic Surgery | 3745 Geist Rd, Fairbanks, AK 99709-3554 | 2013-07-01 |
| 1235448309 | Daniel R Johnson, D.o. | Orthopaedic Surgery | 3745 Geist Rd, Fairbanks, AK 99709-3548 | 2010-10-06 |
| 1629215488 | Orthopaedic Surgical Associates, LLC | Orthopaedic Surgery | 1275 Sadler Way, Suite 101, Fairbanks, AK 99701-3171 | 2009-01-15 |
| 1669619599 | Steese Orthopaedic Associates, LLC | Orthopaedic Surgery | 1405 Kellum St, Suite 101, Fairbanks, AK 99701-4102 | 2009-01-14 |
| 1104099050 | John W. Joosse, Md A PC | Orthopaedic Surgery | 1411 19th Ave, Fairbanks, AK 99701-5902 | 2008-04-10 |
| 1679642714 | George R Vrablik Md Apc | Orthopaedic Surgery | 1919 Lathrop St, Ste 108, Fairbanks, AK 99701 | 2006-11-06 |
| 1114028602 | Robert Denison Dingeman | Orthopaedic Surgery | 751 Old Richardson Hwy, Suite 101, Fairbanks, AK 99701-7813 | 2006-09-26 |
| 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.