Active NPI
Octaivia Tokeinna, CHP-C
- Community Health Worker
- Wales, AK
National Provider Identifier
1083976393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- 12-1179-III
- Practice address
- 530 Hollywood Drive
Wales,, AK 99783 - Phone
- (907) 664-3311
- Fax
- (907) 664-2135
- NPI assigned
- Jun 12, 2012
- Last updated
- May 14, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | 12-1179-III | AK | Primary |
Addresses
Primary practice location
530 Hollywood Drive
Wales,, AK 99783
Mailing address
530 Hollywood Drive
Wales,, AK 99783
Phone (907) 664-3311
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11-1179-III | Other | AK | CHA III |
Other names 1
- Octaivia Wilson
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12-1179-III | AK | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778716800000",
"number": "1083976393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "530 HOLLYWOOD DRIVE",
"city": "WALES,",
"state": "AK",
"postal_code": "99783",
"telephone_number": "907-664-3311",
"fax_number": "907-664-2135"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 HOLLYWOOD DRIVE",
"city": "WALES,",
"state": "AK",
"postal_code": "99783",
"telephone_number": "907-664-3311",
"fax_number": "907-664-2135"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOKEINNA",
"first_name": "OCTAIVIA",
"name_prefix": "Mrs.",
"credential": "CHP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-12",
"last_updated": "2026-05-14",
"certification_date": "2026-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "AK",
"license": "12-1179-III",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHA III",
"identifier": "11-1179-III",
"state": "AK"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "OCTAIVIA",
"last_name": "WILSON",
"credential": "CHP-C",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Wales, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.