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ALASKA INTERNAL MEDICINE & PEDIATRICS LLC NPI 1366580912


NPI Record

The following NPI record includes the field values provided by the NPPES as well as the field definition as published in the Federal Register. The complete NPI record is also available for download in text, csv and xml formats.

Field NameField ValueDefinition 1
NPI 1366580912 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code 2 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Provider Organization Name Legal Business Name ALASKA INTERNAL MEDICINE & PEDIATRICS LLC The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider First Line Business Practice Location Address 4048 LAUREL ST STE 306 The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name ANCHORAGE The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name AK The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code 995085391 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number 9077707800 The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number 9079294660 The fax number associated with the location address of the provider being identified.
Provider Enumeration Date 2/2/2007 The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date 6/26/2008 The date that a record was last updated or changed.
Authorized Official Last Name O'FALLON The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name MICHELE The first name of the authorized official.
Authorized Official Middle Name L The middle name of the authorized official.
Authorized Official Title or Position OWNER The title or position of the authorized official.
Authorized Official Telephone Number 9077707800 The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1 174400000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1 AA3566 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1 AK The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1 N
Healthcare Provider Taxonomy Code 2 174400000X
Provider License Number 2 2342 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 2 AK The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 2 Y
Other Provider Identifier 1 MD2282 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 1 05 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 1 AK
Other Provider Identifier 2 1902877251 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 2 01 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 2 AK
Other Provider Identifier Issuer 2 O'FALLON (NPI)
Other Provider Identifier 3 MD7864 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 3 05 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 3 AK
Other Provider Identifier 4 1710958061 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 4 01 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 4 AK
Other Provider Identifier Issuer 4 MONTANO (NPI)
Is Organization Subpart N
Authorized Official Name Prefix Text DR.
Authorized Official Credential Text M.D.
Healthcare Provider Taxonomy Group 1 193200000X MULTI-SPECIALTY GROUP
Healthcare Provider Taxonomy Group 2 193200000X MULTI-SPECIALTY GROUP

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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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: 11/14/2023

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.