Katie's Way Fairbanks, LLC

Primary specialty

Behavioral Neurology & Neuropsychiatry PhysicianTaxonomy code 2084B0040X

Legal business name

KATIE'S WAY FAIRBANKS, LLC

Doing business as

Katies Way

Practice address

1275 Sadler Way Ste 104
Fairbanks, AK 99701-3175

Phone

(907) 921-5511

Fax

(907) 921-3574

NPI assigned

Feb 10, 2023

Organization subpart

No

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

Authorized official

Name

Kelly Rae Johnson

Title

Credentialing Director

Phone

(785) 320-6616

Specialties & licenses 15

Addresses

Other names 1

• KATIES WAY Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Caleb Lee Jordan

  • Psychiatry Physician
  • Roslindale, MA
  • NPI 1619361904
  NPD (past)
• Jeffrey C Mathis, OTD/L,CHT

  • Occupational Therapist
  • Manhattan, KS
  • NPI 1861504755
  NPD (past)

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

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    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732060800000",
    "number": "1144927096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 SADLER WAY STE 102",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997013175",
            "telephone_number": "907-921-5511",
            "fax_number": "907-921-3574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 SADLER WAY STE 104",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997013175",
            "telephone_number": "907-921-5511",
            "fax_number": "907-921-3574"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "257 Santa Claus Ln",
            "address_purpose": "LOCATION",
            "city": "North Pole",
            "state": "AK",
            "postal_code": "997056055",
            "country_code": "US",
            "telephone_number": "907-921-5511",
            "fax_number": "907-921-3574",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KATIE'S WAY FAIRBANKS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-10",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "CREDENTIALING DIRECTOR",
        "authorized_official_telephone_number": "785-320-6616"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
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        },
        {
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        },
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        },
        {
            "code": "103TB0200X",
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        {
            "code": "103TP0814X",
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        },
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        },
        {
            "code": "106H00000X",
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            "desc": "Marriage & Family Therapist",
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        },
        {
            "code": "202D00000X",
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        {
            "code": "207QA0505X",
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        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
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        },
        {
            "code": "2084B0040X",
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            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
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        },
        {
            "code": "2084P0015X",
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        {
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        {
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        },
        {
            "code": "363LP0808X",
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            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
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        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
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            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Okreipan Kaping, DDS
• Kathleen Marie Karella, OTRL
• Yoshihiro William Karino
• Karolina Priebe DNP PC (Alaska Lifestyle and Weight Loss Center)
• Katherine E Johnson, MD PC (Mountain View Eye Center)
• Yukiko Kawano
• Aimee Kaye Svendsen, ND
• MJ Kayouktuk
• Cecily Kearse
• Keldrick Kearse

• Behavioral Neurology & Neuropsychiatry Physician in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Behavioral Neurology & Neuropsychiatry Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; 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.