Active NPI
Jacquelyn Johnson, OTD/R/L
- Occupational Therapist
- Palmer, AK
National Provider Identifier
1891180402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2846
- Practice address
- 809 S Chugach St Ste 1
Palmer, AK 99645-6665 - Phone
- (907) 746-4373
- Fax
- (907) 746-4376
- NPI assigned
- Mar 31, 2015
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 2846 | AK | Primary |
Addresses
Primary practice location
809 S Chugach St Ste 1
Palmer, AK 99645-6665
Mailing address
809 S Chugach St Ste 1
Palmer, AK 99645-6665
Phone (907) 746-4373
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2846 | AK | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427760000000",
"number": "1891180402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "809 S CHUGACH ST STE 1",
"city": "PALMER",
"state": "AK",
"postal_code": "996456665",
"telephone_number": "907-746-4373",
"fax_number": "907-746-4376"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "809 S CHUGACH ST STE 1",
"city": "PALMER",
"state": "AK",
"postal_code": "996456665",
"telephone_number": "907-746-4373",
"fax_number": "907-746-4376"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "JACQUELYN",
"credential": "OTD/R/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-03-31",
"last_updated": "2015-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AK",
"license": "2846",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palmer, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.