Active NPI
Brian Ahlo
- Counselor
- Bethel, AK
National Provider Identifier
1164876694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 381 4TH Avenue
Bethel, AK 99559-0528 - Phone
- (907) 543-2242
- Fax
- (907) 543-1481
- NPI assigned
- Apr 21, 2016
- Last updated
- Dec 26, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary | ||
| Day Training/Habilitation Specialist | 373H00000X |
Addresses
Primary practice location
381 4TH Avenue
Bethel, AK 99559-0528
Mailing address
PO Box 3227
Bethel, AK 99559-3227
Phone (907) 543-2242
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1020986 | Medicaid | AK |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545782400000",
"number": "1164876694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3227",
"city": "BETHEL",
"state": "AK",
"postal_code": "995593227",
"telephone_number": "907-543-2242",
"fax_number": "907-543-1481"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "381 4TH AVENUE",
"city": "BETHEL",
"state": "AK",
"postal_code": "995590528",
"telephone_number": "907-543-2242",
"fax_number": "907-543-1481"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AHLO",
"first_name": "BRIAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-04-21",
"last_updated": "2018-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
},
{
"code": "373H00000X",
"taxonomy_group": "",
"desc": "Day Training/Habilitation Specialist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1020986",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bethel, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.