Active NPI
Katherine Corcoran Walter
- Occupational Therapist
- Bethel, AK
National Provider Identifier
1093104267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 103447
- Practice address
- 837 Chief Eddie Hoffman Hwy
Bethel, AK 99559 - Phone
- (907) 543-3690
- Fax
- (907) 543-1276
- NPI assigned
- Jan 12, 2015
- Last updated
- Aug 24, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OTPOTLIC3346 | MT | |
| Occupational Therapist | 225X00000X | 2086 | NH | |
| Occupational Therapist | 225X00000X | OT2331 | ME | |
| Occupational Therapist | 225X00000X | 103447 | AK | Primary |
Addresses
Primary practice location
837 Chief Eddie Hoffman Hwy
Bethel, AK 99559
Mailing address
PO Box 200
Dayton, MT 59914-0200
Phone (406) 206-5692
Other practice location 1
202 5th Ave E
Polson, MT 59860-2353
Phone (207) 653-9294
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1002573 | Medicaid | AK |
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 |
|---|---|---|---|
| 103447 | AK | MD | Occupational Therapist |
| OT2331 | ME | MD | Occupational Therapist |
| OTPOTLIC3346 | MT | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535068800000",
"number": "1093104267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 200",
"city": "DAYTON",
"state": "MT",
"postal_code": "599140200",
"telephone_number": "406-206-5692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "837 CHIEF EDDIE HOFFMAN HWY",
"city": "BETHEL",
"state": "AK",
"postal_code": "99559",
"telephone_number": "907-543-3690",
"fax_number": "907-543-1276"
}
],
"practiceLocations": [
{
"address_1": "202 5th Ave E",
"address_purpose": "LOCATION",
"city": "Polson",
"state": "MT",
"postal_code": "598602353",
"country_code": "US",
"telephone_number": "207-653-9294",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WALTER",
"first_name": "KATHERINE",
"middle_name": "CORCORAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-01-12",
"last_updated": "2018-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MT",
"license": "OTPOTLIC3346",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NH",
"license": "2086",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "ME",
"license": "OT2331",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AK",
"license": "103447",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1002573",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bethel, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.