MARY HORTON (RN) – Acute Care Nurse Practitioner, NPI 1174086862
Acute Care Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
761 NURSE PRACTITIONER in AK
Provider Addresses for MARY HORTON (RN)
1717 W Cowles St
Fairbanks, AK 997015926
Phone: (907) 451-6682
Type: Location
106, 1st Avenue, Slaterville, Fairbanks, Fairbanks North Star, Alaska, 99701, United States
FAIRBANKS, AK 997014871
Phone: (907) 452-8251
Type: Mailing
1717, West Cowles Street, South Fairbanks, Fairbanks, Fairbanks North Star, Alaska, 99701, United States
FAIRBANKS, AK 997015926
Phone: (907) 451-6682
Type: Location
PO BOX 190930
BOISE, ID 837190930
Phone: (208) 302-9342
Fax: (208) 367-5180
Type: Mailing
999 N CURTIS RD STE 415
BOISE, ID 837061334
Phone: (208) 302-2600
Fax: (208) 302-2625
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-12-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20251204004881 | I | Nurse Practitioner | ID | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 99701)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Qualified Audiologist | ID | |
| Orthopedic Surgery | ID | |
| - | ID | |
| - | UT | |
| Family Practice | ID | |
| Physician Assistant | ID | |
| - | ID | |
| Internal Medicine | ID | |
| Family Practice | ID | |
| - | ID |
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