Individual provider Active NPI

Kathleen Edna Oyoumick

  • Community Health Worker
  • Unalakleet, AK
National Provider Identifier
1801138565
Registry record updated Mar 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
13-1233-III Issued in AK
Practice address
189 N. Happy Valley Rd.
Unalakleet, AK 99684-0189
Phone
(907) 924-3535
Fax
(907) 924-3692
NPI assigned
Mar 20, 2013
Last updated
Mar 20, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X 13-1233-III AK Primary

Addresses

Primary practice location

189 N. Happy Valley Rd.
Unalakleet, AK 99684-0189

Mailing address

189 N. Happy Valley Rd.
Unalakleet, AK 99684-0189
Phone (907) 924-3535

Other identifiers 1

IdentifierTypeStateIssuer
13-1233-IIIOtherAKCHA 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

LicenseStateTypeSpecialty
13-1233-IIIAKMDCommunity Health Worker

NPI Registry JSON

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

{
    "created_epoch": "1363737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363737600000",
    "number": "1801138565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 N. HAPPY VALLEY RD.",
            "city": "UNALAKLEET",
            "state": "AK",
            "postal_code": "996840189",
            "telephone_number": "907-924-3535",
            "fax_number": "907-924-3692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 N. HAPPY VALLEY RD.",
            "city": "UNALAKLEET",
            "state": "AK",
            "postal_code": "996840189",
            "telephone_number": "907-924-3535",
            "fax_number": "907-924-3692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OYOUMICK",
        "first_name": "KATHLEEN",
        "middle_name": "EDNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-20",
        "last_updated": "2013-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "AK",
            "license": "13-1233-III",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHA III",
            "identifier": "13-1233-III",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Unalakleet, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2013; 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.