Samuel Alexander Islas, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT61274559 Issued in WA

Practice address

673 MDG
5955 Zeamer Ave
Jber, AK 99506

Phone

(907) 580-1702

NPI assigned

Sep 1, 2021

Last updated

Oct 25, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1630454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1396413647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "673 MDG",
            "address_2": "5955 ZEAMER AVE",
            "city": "JBER",
            "state": "AK",
            "postal_code": "99506",
            "telephone_number": "907-580-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "673 MDG",
            "address_2": "5955 ZEAMER AVE",
            "city": "JBER",
            "state": "AK",
            "postal_code": "99506",
            "telephone_number": "907-580-1702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISLAS",
        "first_name": "SAMUEL",
        "middle_name": "ALEXANDER",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-01",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT61274559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9720 4th Ave NE",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981152143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Ashley Nicole Harris Hudson, D.D.S., M.S.
• Jason Hunt, M.D.
• Krista K Hutchinson, PT
• Joseph Inhofer, MD
• Rebecca Michelle Jackson, LCSW
• Michael Jessup, FNP-C
• Nathaniel Guy Jimenez
• Megan Ann John, APRN, AGCNS-BC
• David L Johnson, CRNA

• Occupational Therapist in Jber, AK
• Providers in Jber, AK by specialty
• Occupational Therapist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; 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.