Active NPI
Judy Pletnikoff
- Behavior Technician
- Kodiak, AK
National Provider Identifier
1306301114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 916 Stellar Way
Kodiak, AK 99615-6490 - Phone
- (907) 942-1280
- NPI assigned
- Feb 6, 2019
- 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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
916 Stellar Way
Kodiak, AK 99615-6490
Mailing address
PO Box 147
Kodiak, AK 99615-0147
Phone (907) 942-1280
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1004443 | 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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Inclusion Services | Current | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- Kodiak, AK
- NPI 1518191121
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549411200000",
"number": "1306301114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 147",
"city": "KODIAK",
"state": "AK",
"postal_code": "996150147",
"telephone_number": "907-942-1280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "916 STELLAR WAY",
"city": "KODIAK",
"state": "AK",
"postal_code": "996156490",
"telephone_number": "907-942-1280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PLETNIKOFF",
"first_name": "JUDY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-06",
"last_updated": "2019-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1004443",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kodiak, AK
- Doreen Kayla Phillips, BSW, BHP
- Susan Stewart Philo, ED. M.
- Pillars of Care Assisted Living, LLC
- Pkimc Home Health
- Elise Pletnikoff, MD
- Bettye Plyler, LPN
- Terry Wayne Pollard
- Heather Mary Preece, MHSC, RD, LD
- James M Price, LPC, CDC II, MAC
- Providence Health & Services - Washington (Providence Kodiak Home Health)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.