Individual provider Active NPI

Miriam Alejandra Olivo

  • Community Health Worker
  • Kenai, AK
National Provider Identifier
1073332425
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
508 Upland St
Kenai, AK 99611-8026
Phone
(907) 335-7300
NPI assigned
Oct 3, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Community Health Worker 172V00000X AK Primary

Addresses

Primary practice location

508 Upland St
Kenai, AK 99611-8026

Mailing address

51332 Karluk Ave
Kenai, AK 99611-8789
Phone (907) 598-7707

Other identifiers 1

IdentifierTypeStateIssuer
1750718MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1727913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1073332425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51332 KARLUK AVE",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996118789",
            "telephone_number": "907-598-7707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 UPLAND ST",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996118026",
            "telephone_number": "907-335-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVO",
        "first_name": "MIRIAM",
        "middle_name": "ALEJANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-03",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "AK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750718",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenai, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; 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.