Individual provider Active NPI

Marissa Kaye Oxereok

  • Community Health Worker
  • Wales, AK
National Provider Identifier
1174920375
Registry record updated Dec 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
530 Snowbank Rd
Wales, AK 99783
Phone
(907) 664-3311
Fax
(907) 664-3471
NPI assigned
Dec 3, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X Primary

Addresses

Primary practice location

530 Snowbank Rd
Wales, AK 99783

Mailing address

530 Snowbank Rd
Wales, AK 99783
Phone (907) 664-3311

Other identifiers 1

IdentifierTypeStateIssuer
CHA IIIOtherAKCHA III

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": "1417564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417564800000",
    "number": "1174920375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 SNOWBANK RD",
            "city": "WALES",
            "state": "AK",
            "postal_code": "99783",
            "telephone_number": "907-664-3311",
            "fax_number": "907-664-3471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 SNOWBANK RD",
            "city": "WALES",
            "state": "AK",
            "postal_code": "99783",
            "telephone_number": "907-664-3311",
            "fax_number": "907-664-3471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OXEREOK",
        "first_name": "MARISSA",
        "middle_name": "KAYE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-03",
        "last_updated": "2014-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHA III",
            "identifier": "CHA III",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wales, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2014; 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.