ALPINE MEDICAL GROUP LLC
NPI 1114681608
Nurse Practitioner - Family in Fairbanks, AK
NPI Status: Active since October 29, 2021
Contact Information
605 CHIEF THOMAS DR
FAIRBANKS, AK
ZIP 99709
Phone: (907) 455-4555
Fax: (833) 941-2349
- Organization
- Nurse Practitioner
- Family
- Accepts Insurance
- CLIA Number: 02D2271966
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 11-10-2026
About ALPINE MEDICAL GROUP LLC
This page provides the complete NPI Profile along with additional information for Alpine Medical Group Llc, a provider established in Fairbanks, Alaska operating as a Nurse Practitioner, focusing in family . The healthcare provider is registered in the NPI registry with number 1114681608 assigned on October 2021. The practitioner's primary taxonomy code is 363LF0000X. The provider is registered as an organization and their NPI record was last updated one year ago. Alpine Medical Group Llc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Haley Evens Np (Authorized Official)
- NPI
- 1114681608
- Provider Name
- ALPINE MEDICAL GROUP LLC
- Entity Type
- Organization
- Location Address
- 605 CHIEF THOMAS DR FAIRBANKS, AK 99709
- Location Phone
- (907) 455-4555
- Location Fax
- (833) 941-2349
- Mailing Address
- 605 CHIEF THOMAS DR FAIRBANKS, AK 99709
- Mailing Phone
- (907) 455-4555
- Mailing Fax
- (833) 941-2349
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-29-2021
- Last Update Date
- 09-04-2025
- Code Navigator
A nurse practitioner (NP) like Alpine Medical Group Llc is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
Location Map
Secondary Locations
- 2054 30th Ave
Fairbanks, AK 99701
(907) 455-4555
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Nurse Practitioner Family
- Taxonomy Code
- 363LF0000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | |
| 2 | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | |
| 3 | 363LP0200X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | |
| 4 | 363LP2300X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
Group Taxonomy 193400000X MULTIPLE SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Moda Select Alaska Bronze 6500 - PPO
- Moda Select Alaska Bronze HDHP 5500 - PPO
- Moda Select Alaska Gold 1500 - PPO
- Moda Select Alaska Silver 4500 - PPO
- Moda Select Alaska Standard Bronze - PPO
- Moda Select Alaska Standard Gold - PPO
- Moda Select Alaska Standard Silver - PPO
- Moda Select Texas Bronze 8700 ($0 Virtual Urgent Care through CirrusMD) - EPO
- Moda Select Texas Bronze HDHP 7500 - EPO
- Moda Select Texas Standard Bronze - EPO
- Moda Select Texas Standard Gold - EPO
- Moda Select Texas Standard Silver - EPO
- Premera Blue Cross Alaska One Gold - PPO
- Premera Blue Cross Preferred Bronze 5800 HSA - PPO
- Premera Blue Cross Preferred Bronze 6350 - PPO
- Premera Blue Cross Preferred Gold 1500 - PPO
- Premera Blue Cross Preferred Silver 4500 - PPO
- Premera Blue Cross Standard Bronze II - PPO
- Premera Blue Cross Standard Gold - PPO
- Premera Blue Cross Standard Silver - PPO
- Premera Blue Cross Family Dental - PPO
- Premera Blue Cross Pediatric Dental - PPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 02D2271966
- Facility Type
- Physician Office
- Certificate Effective Date
- November 11, 2024
- Certificate Expiration Date
- November 10, 2026
- Laboratory Director
- HALEY EVENS
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Alpine Medical Group Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1114681608, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 52. The final step is to find the difference between that total and the next multiple of ten (60 - 52 = 8).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 52 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1114681608, enumerated as an "organization" on October 29, 2021.
The provider is located at 605 CHIEF THOMAS DR FAIRBANKS, AK 99709 and the phone number is (907) 455-4555.
Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.
The provider might be accepting Accepts: Moda Health Plan, Inc. and Premera Blue Cross Blue. Please consult your insurance carrier or call the provider to verify.
