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GOLD STAR LONGEVITY & WELLNESS LLC NPI 1427532613


NPI Information

NPI: 1427532613
Provider Name: GOLD STAR LONGEVITY & WELLNESS LLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 02D2167773

Address:
751 OLD RICHARDSON HWY STE 200
FAIRBANKS, AK
ZIP 99701
Phone: (907) 457-9420
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GOLD STAR LONGEVITY & WELLNESS LLC is a family medicine in Fairbanks, AK. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. GOLD STAR LONGEVITY & WELLNESS LLC NPI is 1427532613. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

751 OLD RICHARDSON HWY STE 200
FAIRBANKS, AK
ZIP 99701-805
Phone: (907) 457-9420
Fax: (907) 457-1098

The provider's authorized official is Russell Scott Pierce .
The authorized official title is Owner, M.d. and has the following contact phone number (907) 457-9420.

The CLIA number assigned to this NPI record is 02D2167773 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 9/24/2018 and was last updated on 5/11/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineYes
2363LA2200XNurse PractitionerAdult HealthNo
3363LC1500XNurse PractitionerCommunity HealthNo
4363LF0000XNurse PractitionerFamilyNo
5363LG0600XNurse PractitionerGerontologyNo
6363LP0200XNurse PractitionerPediatricsNo
7363LP0808XNurse PractitionerPsychiatric/Mental HealthNo
8363LP2300XNurse PractitionerPrimary CareNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.