Jeanae Dewey, CHA

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

East 2ND Avenue
Ruth Quamiiggan Henry Memorial Clinic
Koyuk, AK 99753

Phone

(907) 963-3311

Fax

(907) 963-3610

NPI assigned

Sep 16, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1473984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473984000000",
    "number": "1104374347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70",
            "city": "KOYUK",
            "state": "AK",
            "postal_code": "99753",
            "telephone_number": "907-963-3311",
            "fax_number": "907-963-3610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EAST 2ND AVENUE",
            "address_2": "RUTH QUAMIIGGAN HENRY MEMORIAL CLINIC",
            "city": "KOYUK",
            "state": "AK",
            "postal_code": "99753",
            "telephone_number": "907-963-3311",
            "fax_number": "907-963-3610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWEY",
        "first_name": "JEANAE",
        "credential": "CHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-16",
        "last_updated": "2016-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "AK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHA",
            "identifier": "CHA",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Annamarie M Adams, CHA-T
• Amy Iris Taylor Charles, CHA-T
• Audrey Hadley, CHA-II
• Aaron Wayne Nassuk
• Cecelia R Nassuk, CHA-T
• Virginia L Nassuk, CHA-T
• Diane Nelson, CHA

• Community Health Worker in Koyuk, AK
• Providers in Koyuk, AK by specialty
• Community Health Worker in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2016; 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.