Individual provider Active NPI

Clyesha Madrey

  • Prosthetics Case Management
  • Anchorage, AK
National Provider Identifier
1477918399
Registry record updated Dec 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetics Case ManagementTaxonomy code 1744P3200X
License
HADH19565 Issued in AK
Practice address
5700 Old Seward Hwy
Suite 205
Anchorage, AK 99518-1473
Phone
(907) 444-7049
NPI assigned
Dec 18, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetics Case Management 1744P3200X HADH19565 AK Primary

Addresses

Primary practice location

5700 Old Seward Hwy
Suite 205
Anchorage, AK 99518-1473

Mailing address

5700 Old Seward Hwy
Suite 205
Anchorage, AK 99518-1473
Phone (907) 444-7049

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
HADH19565AKMDProsthetics Case Management

NPI Registry JSON

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

{
    "created_epoch": "1450396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450396800000",
    "number": "1477918399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 OLD SEWARD HWY",
            "address_2": "SUITE 205",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995181473",
            "telephone_number": "907-444-7049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 OLD SEWARD HWY",
            "address_2": "SUITE 205",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995181473",
            "telephone_number": "907-444-7049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADREY",
        "first_name": "CLYESHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-18",
        "last_updated": "2015-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "AK",
            "license": "HADH19565",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 18, 2015; 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.