Individual provider Active NPI

Keri Jo McEntee, MS, OTR/L

  • Occupational Therapist
  • Sitka, AK
National Provider Identifier
1588339352
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
PHYO2892 Issued in AK
Practice address
209 Moller Ave Ste 102
Sitka, AK 99835-7142
Phone
(907) 966-8969
NPI assigned
Aug 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X PHYO2892 AK Primary

Addresses

Primary practice location

209 Moller Ave Ste 102
Sitka, AK 99835-7142

Mailing address

209 Moller Ave Ste 102
Sitka, AK 99835-7142
Phone (907) 966-8969

Other identifiers 2

IdentifierTypeStateIssuer
70206OtherAKBUSINESS LICENSE NUMBER
1701935MedicaidAK

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
Master of Science

State licenses

LicenseStateTypeSpecialty
PHYO2892AKMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Alaska Regional Health Consortium CurrentSince Aug 15, 2021 Accepting new patients
Southeast Alaska Regional Health Consortium PastSince Aug 15, 2021 Accepting new patients

Locations

209 Moller Ave
Ste 102
Sitka, AK 99835
Phone (907) 966-8969

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1628726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1588339352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 MOLLER AVE STE 102",
            "city": "SITKA",
            "state": "AK",
            "postal_code": "998357142",
            "telephone_number": "907-966-8969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 MOLLER AVE STE 102",
            "city": "SITKA",
            "state": "AK",
            "postal_code": "998357142",
            "telephone_number": "907-966-8969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCENTEE",
        "first_name": "KERI",
        "middle_name": "JO",
        "name_prefix": "Miss",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-12",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AK",
            "license": "PHYO2892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUSINESS LICENSE NUMBER",
            "identifier": "70206",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1701935",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sitka, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.