Fcmhs | |
3830 S Cushman St Fairbanks AK 99701-7530 | |
(907) 452-1575 | |
(907) 455-5287 |
Full Name | Fcmhs |
---|---|
Speciality | Community/Behavioral Health |
Location | 3830 S Cushman St, Fairbanks, Alaska |
Authorized Official Name and Position | Darcie M Shaffer (MEDICAL BILLING MANAGER) |
Authorized Official Contact | 9075631000 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Fcmhs 1423 Peger Rd Fairbanks AK 99709-5169 Ph: (907) 371-1300 | Fcmhs 3830 S Cushman St Fairbanks AK 99701-7530 Ph: (907) 452-1575 |
NPI Number | 1023445871 |
---|---|
Provider Enumeration Date | 10/10/2013 |
Last Update Date | 02/03/2021 |
Certification Date | 02/03/2021 |
Medicare PECOS PAC ID | 6406085562 |
---|---|
Medicare Enrollment ID | O20140212001626 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023445871 | NPI | - | NPPES |
1596091 | Medicaid | AK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
Provider Name | Linda Laverne Keddington |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1760675953 PECOS PAC ID: 6204923493 Enrollment ID: I20170623002254 |
Provider Name | Dianna L Rehn |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1609251669 PECOS PAC ID: 6608100581 Enrollment ID: I20190626002610 |
Provider Name | Virginia Walker |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1609326594 PECOS PAC ID: 3476977901 Enrollment ID: I20200716003260 |
Provider Name | Curt E Wengel |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1801276027 PECOS PAC ID: 3274838750 Enrollment ID: I20200818004170 |
Provider Name | Jason T Martin |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1639507551 PECOS PAC ID: 5092943456 Enrollment ID: I20201001003351 |
Provider Name | Jonathon Edward Blum |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1558928580 PECOS PAC ID: 7012329154 Enrollment ID: I20201215001936 |
Provider Name | Kristin Hansen |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1235732710 PECOS PAC ID: 7517379340 Enrollment ID: I20201218000997 |
Provider Name | Paul L Gaines |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1235575762 PECOS PAC ID: 4183986268 Enrollment ID: I20210115001493 |
Provider Name | Jessica Estes |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1487632709 PECOS PAC ID: 7113959867 Enrollment ID: I20210129000794 |
Provider Name | Marieke Nmn Heatwole |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1841804234 PECOS PAC ID: 0446655310 Enrollment ID: I20210817000326 |
Provider Name | Jared John Martin |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1659860724 PECOS PAC ID: 1951634641 Enrollment ID: I20210921000725 |
Provider Name | Susan B Matthews |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922000736 PECOS PAC ID: 9638115264 Enrollment ID: I20211028003171 |
Provider Name | Eli T Michael |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1073009379 PECOS PAC ID: 6901296250 Enrollment ID: I20211201001469 |
Provider Name | Larry W Kelly |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1487319869 PECOS PAC ID: 9335539428 Enrollment ID: I20211203001471 |
Provider Name | Myra L Kelly |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1053807073 PECOS PAC ID: 8022368703 Enrollment ID: I20220106000780 |
Provider Name | Paige Ann Sullivan |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1982051728 PECOS PAC ID: 0749574325 Enrollment ID: I20220208001442 |
Provider Name | Lauren R Krahling |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1831679703 PECOS PAC ID: 1355738378 Enrollment ID: I20220421001722 |
Provider Name | Amanda L Nalewaja |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1235760703 PECOS PAC ID: 4385025444 Enrollment ID: I20220720002228 |
Provider Name | Amber L Brownell |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1851950406 PECOS PAC ID: 3375929516 Enrollment ID: I20220926002428 |
Provider Name | Katherine Jean Robins |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1831127117 PECOS PAC ID: 4082682547 Enrollment ID: I20221130001039 |
Provider Name | Toni Brent |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1821379561 PECOS PAC ID: 2668633728 Enrollment ID: I20230417002191 |
Provider Name | Emma E Steinzeig |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1144845744 PECOS PAC ID: 3375909963 Enrollment ID: I20230524002697 |
Provider Name | Christian Mortenson |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1285890053 PECOS PAC ID: 6305193731 Enrollment ID: I20230905003945 |
Provider Name | Erum R Ali |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1851890875 PECOS PAC ID: 2264792068 Enrollment ID: I20230922001347 |
Provider Name | Derek Hook |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1700282571 PECOS PAC ID: 3274851183 Enrollment ID: I20230925003625 |
Provider Name | Hannah D Mckinney |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1942920525 PECOS PAC ID: 9638526171 Enrollment ID: I20231106001967 |
Provider Name | Daniel B Waters |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518743236 PECOS PAC ID: 3779930227 Enrollment ID: I20231106002245 |
Provider Name | Lisa A Enea |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477330751 PECOS PAC ID: 3870940109 Enrollment ID: I20231108002243 |
Provider Name | Lavalda J Lyons |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1992587125 PECOS PAC ID: 1759733967 Enrollment ID: I20240123002918 |
Provider Name | Kimberly M Kirkup |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1639855844 PECOS PAC ID: 3971955113 Enrollment ID: I20240123003996 |
Provider Name | Gabriella M Gergel |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1881360907 PECOS PAC ID: 9739523457 Enrollment ID: I20240221000520 |
Provider Name | Nicole M Jenkins |
---|---|
Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1750550646 PECOS PAC ID: 4688018310 Enrollment ID: I20240221000743 |
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