Active NPI
Raleen A McCourry
- Hearing Instrument Specialist
- Wasilla, AK
National Provider Identifier
1124376405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- 84
- Practice address
- 3600 E Wickersham Way
Wasilla, AK 99654-7550 - Phone
- (907) 373-7700
- NPI assigned
- Aug 17, 2012
- 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 |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | 84 | AK | Primary |
Addresses
Primary practice location
3600 E Wickersham Way
Wasilla, AK 99654-7550
Mailing address
3600 E Wickersham Way
Wasilla, AK 99654-7550
Phone (907) 373-7700
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 |
|---|---|---|---|
| 84 | AK | MD | Hearing Instrument Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Otto Inc | Hearing Instrument Specialist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1345161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346716800000",
"number": "1124376405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3600 E WICKERSHAM WAY",
"city": "WASILLA",
"state": "AK",
"postal_code": "996547550",
"telephone_number": "907-373-7700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3600 E WICKERSHAM WAY",
"city": "WASILLA",
"state": "AK",
"postal_code": "996547550",
"telephone_number": "907-373-7700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCOURRY",
"first_name": "RALEEN",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-17",
"last_updated": "2012-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "AK",
"license": "84",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wasilla, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.