Individual provider Active NPI

Chailly Clayton, RN

  • Addiction (Substance Use Disorder) Registered Nurse
  • Juneau, AK
National Provider Identifier
1497328637
Registry record updated Jul 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X
License
NURR23011 Issued in AK
Practice address
3260 Hospital Drive
Withdrawal Management Unit
Juneau, AK 99801
Phone
(907) 796-8289
NPI assigned
Jul 23, 2021
Last updated
Jul 25, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X NURR23011 AK Primary

Addresses

Primary practice location

3260 Hospital Drive
Withdrawal Management Unit
Juneau, AK 99801

Mailing address

3260 Hospital Drive
Withdrawal Management Unit
Juneau, AK 99801

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
NURR23011AKMDAddiction (Substance Use Disorder) Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1626998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627171200000",
    "number": "1497328637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3260 HOSPITAL DRIVE",
            "address_2": "WITHDRAWAL MANAGEMENT UNIT",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "99801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3260 HOSPITAL DRIVE",
            "address_2": "WITHDRAWAL MANAGEMENT UNIT",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "99801",
            "telephone_number": "907-796-8289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAYTON",
        "first_name": "CHAILLY",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-23",
        "last_updated": "2021-07-25",
        "certification_date": "2021-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "AK",
            "license": "NURR23011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Juneau, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2021; 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.