Individual provider Active NPI

Katelynn Zanders Thomson, OTD, OTR/L

  • Occupational Therapist
  • Eagle River, AK
National Provider Identifier
1811665458
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
181907 Issued in AK
Practice address
17101 Snowmobile LN
Suite 202
Eagle River, AK 99577
Phone
(907) 694-8085
NPI assigned
Aug 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 181907 AK Primary

Addresses

Primary practice location

17101 Snowmobile LN
Suite 202
Eagle River, AK 99577

Mailing address

17101 Snowmobile LN
Suite 202
Eagle River, AK 99577
Phone (907) 694-8085

Other names 1

  • Katelynn Ilyesha Zanders Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211209001727 AK Practitioner - Occupational Therapist in Private Practice 5193115954 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
181907AKMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Excellence in Health Chiropractic and Rehabilitation Clinic PC CurrentSince Oct 1, 2021 Accepting new patients

Locations

2008 E Northern Lights Blvd
#100
Anchorage, AK 99508

2008 E Northern Lights Blvd
Anchorage, AK 99508
Phone (907) 562-1511

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1630281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1811665458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17101 SNOWMOBILE LN",
            "address_2": "SUITE 202",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "99577",
            "telephone_number": "907-694-8085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17101 SNOWMOBILE LN",
            "address_2": "SUITE 202",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "99577",
            "telephone_number": "907-694-8085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMSON",
        "first_name": "KATELYNN",
        "middle_name": "ZANDERS",
        "name_prefix": "Dr.",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-30",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AK",
            "license": "181907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATELYNN",
            "last_name": "ZANDERS",
            "middle_name": "ILYESHA",
            "credential": "OTD, OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Eagle River, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.