Individual provider Active NPI

Jeana Campbell Kaufman

  • Physical Rehabilitation Occupational Therapist
  • Anchorage, AK
National Provider Identifier
1760925408
Registry record updated Nov 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X
License
143609 Issued in AK
Practice address
2804 W Northern Lights Blvd
Anchorage, AK 99517-9951
Phone
(907) 250-9260
NPI assigned
Nov 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Rehabilitation Occupational Therapist 225XP0019X 143609 AK Primary

Addresses

Primary practice location

2804 W Northern Lights Blvd
Anchorage, AK 99517-9951

Mailing address

12541 Landmark St
Apt 2
Anchorage, AK 99515-4158
Phone (907) 250-9260

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
143609AKMDPhysical Rehabilitation Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1480377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668816000000",
    "number": "1760925408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12541 LANDMARK ST",
            "address_2": "APT 2",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995154158",
            "telephone_number": "907-250-9260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2804 W NORTHERN LIGHTS BLVD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995179951",
            "telephone_number": "907-250-9260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUFMAN",
        "first_name": "JEANA",
        "middle_name": "CAMPBELL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-29",
        "last_updated": "2022-11-19",
        "certification_date": "2022-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "AK",
            "license": "143609",
            "primary": true
        }
    ],
    "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 Nov 19, 2022; 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.