Active NPI
Carol Koliadko
- Registered Nurse
- Wasilla, AK
National Provider Identifier
1134514698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 21461
- Practice address
- 3223 E Palmer Wasilla Hwy Ste 3
Suite #3
Wasilla, AK 99654-7277 - Phone
- (907) 352-6630
- Fax
- (907) 376-3096
- NPI assigned
- Apr 1, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 21461 | AK | Primary |
Addresses
Primary practice location
3223 E Palmer Wasilla Hwy Ste 3
Suite #3
Wasilla, AK 99654-7277
Mailing address
3223 E Palmer Wasilla Hwy Ste 3
Suite #3
Wasilla, AK 99654-7277
Phone (907) 352-6630
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 |
|---|---|---|---|
| 21461 | AK | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of Alaska Department of Administration | Past | Accepting new patients | |
| State of Alaska | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Public Health or Welfare Agency
- Wasilla, AK
- NPI 1205958287
-
- Psychiatric Hospital
- Anchorage, AK
- NPI 1497842553
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427846400000",
"number": "1134514698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3223 E PALMER WASILLA HWY STE 3",
"address_2": "SUITE #3",
"city": "WASILLA",
"state": "AK",
"postal_code": "996547277",
"telephone_number": "907-352-6630",
"fax_number": "907-376-3096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3223 E PALMER WASILLA HWY STE 3",
"address_2": "SUITE #3",
"city": "WASILLA",
"state": "AK",
"postal_code": "996547277",
"telephone_number": "907-352-6630",
"fax_number": "907-376-3096"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOLIADKO",
"first_name": "CAROL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-01",
"last_updated": "2015-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "AK",
"license": "21461",
"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 Apr 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.