Individual provider Active NPI

Nathan Missler, OTRL

  • Occupational Therapist
  • Wasilla, AK
National Provider Identifier
1295280915
Registry record updated May 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
114090 Issued in AK
Practice address
650 N Shoreline Dr
Wasilla, AK 99654-6677
Phone
(907) 376-6363
Fax
(907) 376-6366
NPI assigned
Aug 23, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2020

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 114090 AK Primary

Addresses

Primary practice location

650 N Shoreline Dr
Wasilla, AK 99654-6677

Mailing address

650 N Shoreline Dr
Wasilla, AK 99654-6677
Phone (907) 376-6363

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160923002066 AK Practitioner - Occupational Therapist in Private Practice 1951698695

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Wayne State University School of Medicine, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3600 Lake Otis Pkwy
Suite 202
Anchorage, AK 99508-5225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Laurie Hartleydba Advanced Hand & Orthopedics PastSince Dec 21, 2020 Accepting new patients
Orthoalaska LLC PastSince Jan 21, 2024 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1471910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590710400000",
    "number": "1295280915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 N SHORELINE DR",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996546677",
            "telephone_number": "907-376-6363",
            "fax_number": "907-376-6366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 N SHORELINE DR",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996546677",
            "telephone_number": "907-376-6363",
            "fax_number": "907-376-6366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISSLER",
        "first_name": "NATHAN",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-23",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AK",
            "license": "114090",
            "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 May 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.