Active NPI
Jana Hoan Zeedyk, PH.D.
- Clinical Psychologist
- Anchorage, AK
National Provider Identifier
1457597767
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 635
- Practice address
- 2549 Cottonwood St
Anchorage, AK 99508-3933 - Phone
- (907) 222-2670
- Fax
- (907) 222-2670
- NPI assigned
- Dec 17, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 628 | OR | |
| Clinical Psychologist | 103TC0700X | 635 | AK | Primary |
Addresses
Primary practice location
2549 Cottonwood St
Anchorage, AK 99508-3933
Mailing address
2549 Cottonwood St
Anchorage, AK 99508-3933
Phone (907) 222-2670
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 112151 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1980
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
2549 Cottonwood St
Anchorage, AK 99508-3933
Phone (907) 222-2670
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 628 | OR | MD | Clinical Psychologist |
| 635 | AK | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Goodlife Journey Inc. | 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 and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Anchorage, AK
- NPI 1831859321
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1229472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552521600000",
"number": "1457597767",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2549 COTTONWOOD ST",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995083933",
"telephone_number": "907-222-2670",
"fax_number": "907-222-2670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2549 COTTONWOOD ST",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995083933",
"telephone_number": "907-222-2670",
"fax_number": "907-222-2670"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZEEDYK",
"first_name": "JANA",
"middle_name": "HOAN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-12-17",
"last_updated": "2019-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OR",
"license": "628",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AK",
"license": "635",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "112151",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Anchorage, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.