Individual provider Active NPI

McKenzie Stock, OT

  • Occupational Therapist
  • Anchorage, AK
National Provider Identifier
1225681786
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
223742 Issued in AK
Practice address
1200 W Northern Lights Blvd Ste a
Anchorage, AK 99503-3652
Phone
(907) 212-2090
Fax
(907) 212-2570
NPI assigned
Jul 23, 2019
Last updated
May 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 223742 AK Primary

Addresses

Primary practice location

1200 W Northern Lights Blvd Ste a
Anchorage, AK 99503-3652

Mailing address

PO Box 4105
Portland, OR 97208-4105
Phone (866) 907-1068

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240607001798 AK Practitioner - Occupational Therapist in Private Practice 7214479088 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
223742AKMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services- Washington CurrentSince May 24, 2024 Accepting new patients
Early Learning for Everyone PastSince Jul 28, 2019 Accepting new patients
Providence Health & Services-Washington PastSince May 24, 2024 Accepting new patients

Locations

1200 W Northern Lights Blvd
Ste A
Anchorage, AK 99503
Phone (907) 212-2090

3300 Providence Dr
Ste B302
Anchorage, AK 99508
Phone (907) 212-2090

920 Compassion Cir
Anchorage, AK 99504
Phone (907) 212-9200

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1563840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1225681786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4105",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084105",
            "telephone_number": "866-907-1068",
            "fax_number": "425-917-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W NORTHERN LIGHTS BLVD STE A",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995033652",
            "telephone_number": "907-212-2090",
            "fax_number": "907-212-2570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCK",
        "first_name": "MCKENZIE",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-23",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AK",
            "license": "223742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.