Alisha Neloms

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Practice address

9119 Mil Park Ave
Fort Lewis, WA 98433

Phone

(253) 966-9960

NPI assigned

Apr 8, 2022

Last updated

Apr 8, 2022By the provider in NPPES

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

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": "1649376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649376000000",
    "number": "1104568328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FULTON DENTAL CLINIC",
            "address_2": "BLDG 9119 MIL PARK AVE",
            "city": "JBLM",
            "state": "WA",
            "postal_code": "98433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9119 MIL PARK AVE",
            "city": "FORT LEWIS",
            "state": "WA",
            "postal_code": "98433",
            "telephone_number": "253-966-9960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELOMS",
        "first_name": "ALISHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-08",
        "last_updated": "2022-04-08",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scot K Mohr, PHYSICIAN ASSISTNAT
• Lori Moore
• National Vision, Inc.
• National Vision, Inc. (Ft. Lewis Optometry Clinic)
• National Vision, Inc.
• Nico Rouse Corporation
• J. Charlene Perryman, PSYD
• Clea Peterson, RDH
• Joel T. Postma, OD
• Greg Michael Reger, PHD

• Dental Clinic/Center in Fort Lewis, WA
• Providers in Fort Lewis, WA by specialty
• Dental Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; 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.