Kaili Nielsen, DPT

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

168116 Issued in AK

Practice address

8390 Airport Blvd Ste 203
Juneau, AK 99801-6927

Phone

(907) 789-4165

NPI assigned

Dec 3, 2020

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 names 1

• Kaili Jackson Former name

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Juneau Bone & Joint Center, LLC.

  • Orthopaedic Surgery Physician
  • Juneau, AK
  • NPI 1699808139

  Physical Medicine & Rehabilitation

  NPD

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

{
    "created_epoch": "1606953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1487259677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8390 AIRPORT BLVD STE 203",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998016927",
            "telephone_number": "907-789-4165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8390 AIRPORT BLVD STE 203",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998016927",
            "telephone_number": "907-789-4165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "KAILI",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-03",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "AK",
            "license": "168116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAILI",
            "last_name": "JACKSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Reeve Scott Newton, DDS
• Joy Marasco Neyhart, D.O.
• David Nichols
• Dennis Allan Nichols
• Ian Niecko
• Masayo Nishiyama
• Nizich Family Dental LLC
• Anthony Francis Nizich, DMD
• Madison Nolan Grimes, CDM, CPM
• Montana Nolan

• All providers in Juneau, AK
• Physical Medicine & Rehabilitation Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.