Individual provider Active NPI

Joenathan Servito

  • Medical-Surgical Registered Nurse
  • Sitka, AK
National Provider Identifier
1093056848
Registry record updated Mar 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Registered NurseTaxonomy code 163WM0705X
License
33565 Issued in AK
Practice address
222 Tongass Dr
Mount Edgecumbe Hospital
Sitka, AK 99835-9416
Phone
(907) 966-8900
NPI assigned
Mar 4, 2013
Last updated
Mar 4, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 33565 AK Primary

Addresses

Primary practice location

222 Tongass Dr
Mount Edgecumbe Hospital
Sitka, AK 99835-9416

Mailing address

222 Tongass Dr
Mount Edgecumbe Hospital
Sitka, AK 99835-9416

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

LicenseStateTypeSpecialty
33565AKMDMedical-Surgical Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1362355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362355200000",
    "number": "1093056848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 TONGASS DR",
            "address_2": "MOUNT EDGECUMBE HOSPITAL",
            "city": "SITKA",
            "state": "AK",
            "postal_code": "998359416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 TONGASS DR",
            "address_2": "MOUNT EDGECUMBE HOSPITAL",
            "city": "SITKA",
            "state": "AK",
            "postal_code": "998359416",
            "telephone_number": "907-966-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERVITO",
        "first_name": "JOENATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-04",
        "last_updated": "2013-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "AK",
            "license": "33565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sitka, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2013; 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.