Active NPI
Jessica Mitchell, PTA
- Physical Therapist
- Wasilla, AK
National Provider Identifier
1245457340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1719
- Practice address
- 3035 Palmer Wasilla Hwy
Ste 401
Wasilla, AK 99654-7234 - Phone
- (907) 376-8590
- Fax
- (907) 376-8584
- NPI assigned
- Apr 19, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1719 | AK | Primary |
Addresses
Primary practice location
3035 Palmer Wasilla Hwy
Ste 401
Wasilla, AK 99654-7234
Mailing address
1917 Abbott Rd Ste 200
Anchorage, AK 99507-3448
Phone (907) 743-8228
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1719 | AK | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Physical Therapy Inc | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Anchorage, AK
- NPI 1437214459
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1245457340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1917 ABBOTT RD STE 200",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995073448",
"telephone_number": "907-743-8228",
"fax_number": "907-743-8283"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3035 PALMER WASILLA HWY",
"address_2": "STE 401",
"city": "WASILLA",
"state": "AK",
"postal_code": "996547234",
"telephone_number": "907-376-8590",
"fax_number": "907-376-8584"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "JESSICA",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AK",
"license": "1719",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wasilla, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.