Individual provider Active NPI

Kamber D Dewitt

  • Behavior Technician
  • Eagle River, AK
National Provider Identifier
1427564210
Registry record updated Dec 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
7611463 Issued in AK
Practice address
16941 N Eagle River Loop Rd Ste 3
Eagle River, AK 99577-7824
Phone
(907) 726-5330
NPI assigned
Dec 16, 2017
Last updated
Dec 16, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 7611463 AK Primary

Addresses

Primary practice location

16941 N Eagle River Loop Rd Ste 3
Eagle River, AK 99577-7824

Mailing address

16941 N Eagle River Loop Rd Ste 3
Eagle River, AK 99577-7824
Phone (907) 726-5330

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

LicenseStateTypeSpecialty
7611463AKMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1513382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513382400000",
    "number": "1427564210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16941 N EAGLE RIVER LOOP RD STE 3",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777824",
            "telephone_number": "907-726-5330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16941 N EAGLE RIVER LOOP RD STE 3",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777824",
            "telephone_number": "907-726-5330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWITT",
        "first_name": "KAMBER",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-16",
        "last_updated": "2017-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "AK",
            "license": "7611463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle River, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2017; 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.