Active NPI
Brianne Gologergen
- Community Health Worker
- Savoonga, AK
National Provider Identifier
1689090227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- 121213III
- Practice address
- First Blue Building to the Right When Leave Airport
Box 151
Savoonga, AK 99769 - Phone
- (907) 984-6513
- Fax
- (907) 984-6068
- NPI assigned
- Mar 6, 2014
- Last updated
- Mar 6, 2014
- 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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | 121213III | AK | Primary |
Addresses
Primary practice location
First Blue Building to the Right When Leave Airport
Box 151
Savoonga, AK 99769
Mailing address
PO Box 151
Savoonga, AK 99769
Phone (907) 984-6513
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12-1213-III | Other | AK | CHA III |
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 |
|---|---|---|---|
| 121213III | AK | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1394064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1394064000000",
"number": "1689090227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 151",
"city": "SAVOONGA",
"state": "AK",
"postal_code": "99769",
"telephone_number": "907-984-6513",
"fax_number": "907-984-6068"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "FIRST BLUE BUILDING TO THE RIGHT WHEN LEAVE AIRPORT",
"address_2": "BOX 151",
"city": "SAVOONGA",
"state": "AK",
"postal_code": "99769",
"telephone_number": "907-984-6513",
"fax_number": "907-984-6068"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLOGERGEN",
"first_name": "BRIANNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-03-06",
"last_updated": "2014-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "AK",
"license": "121213III",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHA III",
"identifier": "12-1213-III",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Savoonga, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.