Jennifer A Pelka

Key facts

NPI

1154053379

Entity type

Individual (NPI type 1)

Primary specialty

Personal Care Attendant 3747P1801X

License

1712359 (AK)

Practice address

44661 Sterling Hwy Ste a
Soldotna, AK 99669-7900

Phone

(907) 929-5826

NPI assigned

Jun 27, 2022

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

Other identifiers

Electronic endpoints

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 27, 2022.

{
    "created_epoch": "1656288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1154053379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44661 STERLING HWY STE A",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697900",
            "telephone_number": "907-929-5826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44661 STERLING HWY STE A",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697900",
            "telephone_number": "907-929-5826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELKA",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-27",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "AK",
            "license": "1712359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1712359",
            "state": "AK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Heartsandhandsofcare.com",
            "affiliation": "N",
            "endpointDescription": "Hearts and Hands Of Care, Inc.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "44661 Sterling Hwy Ste A",
            "city": "Soldotna",
            "state": "AK",
            "country_code": "US",
            "postal_code": "996697900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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All providers in Soldotna, AK · Personal Care Attendant in Alaska