Phillip Anthony Jordinelli, CDCS, NCACI, SAP

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

2279 Issued in AK

Practice address

3449 E Rezanof Dr
Kodiak, AK 99615-6952

Phone

(907) 486-9823

Fax

(907) 486-9898

NPI assigned

Jun 19, 2013

Sex

Male

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1371600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596672000000",
    "number": "1144669466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3449 E REZANOF DR",
            "city": "KODIAK",
            "state": "AK",
            "postal_code": "996156952",
            "telephone_number": "907-486-7381",
            "fax_number": "907-486-7398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3449 E REZANOF DR",
            "city": "KODIAK",
            "state": "AK",
            "postal_code": "996156952",
            "telephone_number": "907-486-9823",
            "fax_number": "907-486-9898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDINELLI",
        "first_name": "PHILLIP",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "CDCS, NCACI, SAP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-19",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AK",
            "license": "2279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Dawn Johnson, HEALTH SERVICES TECH
• Mark Anthony Johnson, PHARM.D.
• Amie K Jones, BHC II, CDC I
• Evan John Jones II, MD
• Shana J Jones, RN
• Carolyn Judd, LMT
• Carol Juergens, MD
• Julie Kaiser, BHA-I
• Kaliedoscope Assisted Living Home
• Marita - Kaplan

• Addiction (Substance Use Disorder) Counselor in Kodiak, AK
• Providers in Kodiak, AK by specialty
• Addiction (Substance Use Disorder) Counselor in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2020; 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.