Active NPI
Kaia E Pearson, MD
- Family Medicine Physician
- Anchorage, AK
National Provider Identifier
1528416559
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 110872
- Practice address
- 1201 E 36TH Ave
Anchorage, AK 99508-4372 - Phone
- (907) 562-9229
- Fax
- (907) 561-4806
- NPI assigned
- May 31, 2016
- Last updated
- Jul 19, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 110872 | AK | Primary |
Addresses
Primary practice location
1201 E 36TH Ave
Anchorage, AK 99508-4372
Mailing address
PO Box 4105
Portland, OR 97208-4105
Phone (866) 907-1068
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1647341 | Medicaid | AK |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 110872 | AK | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yukon-Kuskokwim Health Corporation | Past | Accepting new patients |
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/663c4c6d-1396-44a4-b589-c11a968d4876/
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Yukon Kuskokwim Delta Regional Hospital
- Rural Acute Care Hospital
- Bethel, AK
- NPI 1063567691
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468886400000",
"number": "1528416559",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4105",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972084105",
"telephone_number": "866-907-1068",
"fax_number": "425-917-9141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 E 36TH AVE",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995084372",
"telephone_number": "907-562-9229",
"fax_number": "907-561-4806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEARSON",
"first_name": "KAIA",
"middle_name": "E",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-31",
"last_updated": "2016-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AK",
"license": "110872",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1647341",
"state": "AK"
}
],
"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 Jul 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.