Individual provider Active NPI

Amanda Marie Hall

  • Pediatric Occupational Therapist
  • Anchorage, AK
National Provider Identifier
1639323868
Registry record updated Jun 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
NO. 2921 Issued in AK
Practice address
4325 Laurel St
Suite 102
Anchorage, AK 99508-5364
Phone
(907) 569-5660
Fax
(185) 544-9448
NPI assigned
Nov 14, 2008
Last updated
Jun 4, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X NO. 2921 AK
Pediatric Occupational Therapist 225XP0200X NO. 2921 AK Primary
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

4325 Laurel St
Suite 102
Anchorage, AK 99508-5364

Mailing address

4325 Laurel St
Suite 102
Anchorage, AK 99508-5364
Phone (907) 569-5660

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

LicenseStateTypeSpecialty
NO. 2921AKMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1226620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433376000000",
    "number": "1639323868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4325 LAUREL ST",
            "address_2": "SUITE 102",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085364",
            "telephone_number": "907-569-5660",
            "fax_number": "185-544-9448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4325 LAUREL ST",
            "address_2": "SUITE 102",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085364",
            "telephone_number": "907-569-5660",
            "fax_number": "185-544-9448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-14",
        "last_updated": "2015-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AK",
            "license": "NO. 2921",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "AK",
            "license": "NO. 2921",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Jun 4, 2015; 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.