Tia Katcheak, CHA III

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

12-1167-III Issued in AK

Practice address

50 Airport Road
Stebbins, AK 99671-0500

Phone

(907) 934-3311

Fax

(907) 934-3312

NPI assigned

Mar 28, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tia Snowball Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332892800000",
    "number": "1023384641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 AIRPORT ROAD",
            "city": "STEBBINS",
            "state": "AK",
            "postal_code": "996710500",
            "telephone_number": "907-934-3311",
            "fax_number": "907-934-3312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 AIRPORT ROAD",
            "city": "STEBBINS",
            "state": "AK",
            "postal_code": "996710500",
            "telephone_number": "907-934-3311",
            "fax_number": "907-934-3312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATCHEAK",
        "first_name": "TIA",
        "name_prefix": "Mrs.",
        "credential": "CHA III",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-28",
        "last_updated": "2012-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "AK",
            "license": "12-1167-III",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHA III",
            "identifier": "12-1167-III",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIA",
            "last_name": "SNOWBALL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Graceann C Atchak, CHA-I
• Tamara Atchak, CHA-T
• Deyonne Coffey-Milligrock
• Marlene C Katcheak, CHA III
• Stacey Matthias-Okitkun, CHA III
• Allison C Nashoanak, CHA-T
• Joan Nashoanak
• Alicia C Niksik, CHA-T
• Norton Sound Health Corporation

• All providers in Stebbins, AK
• Community Health Worker in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.