Active NPI
Jeffrey Deeter, CHA III
- Community Health Worker
- Dot Lake, AK
National Provider Identifier
1609147537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- 11-1125-III
- Practice address
- # 8 Charles St.
Dot Lake, AK 99737 - Phone
- (907) 882-2737
- NPI assigned
- Jan 24, 2012
- Last updated
- Jan 24, 2012
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | 11-1125-III | AK | Primary |
Addresses
Primary practice location
# 8 Charles St.
Dot Lake, AK 99737
Mailing address
# 8 Charles St.
Dot Lake, AK 99737
Phone (907) 882-2737
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11-1125-III | AK | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327363200000",
"number": "1609147537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "# 8 CHARLES ST.",
"city": "DOT LAKE",
"state": "AK",
"postal_code": "99737",
"telephone_number": "907-882-2737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "# 8 CHARLES ST.",
"city": "DOT LAKE",
"state": "AK",
"postal_code": "99737",
"telephone_number": "907-882-2737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEETER",
"first_name": "JEFFREY",
"credential": "CHA III",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-01-24",
"last_updated": "2012-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "AK",
"license": "11-1125-III",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dot Lake, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.