Marilyn Koezuna-Irelan

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

306 West 5TH Avenue
Nome, AK 99762-0966

Phone

(907) 443-3311

Fax

(907) 443-7983

NPI assigned

Jun 22, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245628800000",
    "number": "1366679938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 WEST 5TH AVENUE",
            "city": "NOME",
            "state": "AK",
            "postal_code": "997620966",
            "telephone_number": "907-443-3311",
            "fax_number": "907-443-7983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 WEST 5TH AVENUE",
            "city": "NOME",
            "state": "AK",
            "postal_code": "997620966",
            "telephone_number": "907-443-3311",
            "fax_number": "907-443-7983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEZUNA-IRELAN",
        "first_name": "MARILYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-22",
        "last_updated": "2009-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CMG414",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HC4141",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kamey Kapp, O.D.
• Kawerak Inc (Jacobs House)
• Mark W Kelso, DDS
• Renee Rose Kimaktoak, CHA-T
• Shannon Marie Klescewski
• Geena Koonooka
• Ina Koonooka
• Marina Koonooka, CHA-T
• Melissa M Kost, CHA-T
• Rhoda E Kotongan, CHA-T

• Case Manager/Care Coordinator in Nome, AK
• Providers in Nome, AK by specialty
• Case Manager/Care Coordinator in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2009; 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.