Fairbanks Clinic Inc - Medicare Primary Care in Fairbanks, AK

Fairbanks Clinic Inc is a medicare enrolled primary clinic (Clinic/center) in Fairbanks, Alaska. The current practice location for Fairbanks Clinic Inc is 1405 Kellum St Ste 201, Fairbanks, Alaska. For appointments, you can reach them via phone at (907) 452-1761. The mailing address for Fairbanks Clinic Inc is 607 Old Steese Hwy Ste B307, Fairbanks, Alaska and phone number is (907) 452-1761.

Fairbanks Clinic Inc is licensed to practice in Alaska (license number 4311). The clinic also participates in the medicare program and its NPI number is 1073636148. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (907) 452-1761.

Contact Information

Fairbanks Clinic Inc
1405 Kellum St Ste 201
Fairbanks
AK 99701-4189
(907) 452-1761
(844) 531-0274

Primary Care Clinic Profile

Full NameFairbanks Clinic Inc
SpecialityClinic/Center
Location1405 Kellum St Ste 201, Fairbanks, Alaska
Authorized Official Name and PositionTony Nimeh (OWNER)
Authorized Official Contact6176866809
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Fairbanks Clinic Inc
607 Old Steese Hwy Ste B307
Fairbanks
AK 99701-3163

Ph: (907) 452-1761
Fairbanks Clinic Inc
1405 Kellum St Ste 201
Fairbanks
AK 99701-4189

Ph: (907) 452-1761

NPI Details:

NPI Number1073636148
Provider Enumeration Date04/06/2007
Last Update Date12/10/2020

Medicare PECOS Information:

Medicare PECOS PAC ID3971494519
Medicare Enrollment IDO20040323000568

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Medical Identifiers

Medical identifiers for Fairbanks Clinic Inc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1073636148NPI-NPPES
1004328MedicaidAK

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261Q00000XClinic/center 4311 (Alaska)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Fairbanks Clinic Inc acts as a billing entity for following providers:
Provider NameBart D Worthington
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1205274347
PECOS PAC ID: 9739481193
Enrollment ID: I20200929002996

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Provider NameFerdinand Akoh
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1154893618
PECOS PAC ID: 5799119194
Enrollment ID: I20220622001735

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Provider NameTorrence Nicholson
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1437317385
PECOS PAC ID: 2769524982
Enrollment ID: I20220919001017

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