Jessika Larue, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

130306 Issued in AK

Practice address

35105 Kenai Spur Hwy Ste a
Soldotna, AK 99669-7658

Phone

(907) 260-7444

NPI assigned

Nov 11, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Jessika McClune Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1447200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1902279011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35105 KENAI SPUR HWY STE A",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697658",
            "telephone_number": "907-260-7444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35105 KENAI SPUR HWY STE A",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697658",
            "telephone_number": "907-260-7444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2519 Cove Ave",
            "address_purpose": "LOCATION",
            "city": "LA Grande",
            "state": "OR",
            "postal_code": "978503910",
            "country_code": "US",
            "telephone_number": "541-962-0830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARUE",
        "first_name": "JESSIKA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-11",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "61026",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "130306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902279011",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSIKA",
            "last_name": "MCCLUNE",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Helga Lang, PT
• Leigh Langham, RN
• Brian Edward Larson, DC
• Jason Larson, RRT
• Sonia Larssen
• Tara D Lathrop, M.D.
• Jason Lattin, M.D.
• Erin Lawton, PA-C
• Justin Lazenby, RBT
• Phillip R Lazenby

• Physical Therapist in Soldotna, AK
• Providers in Soldotna, AK by specialty
• Physical Therapist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2020; 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.