Active NPI
Katrina Anne Rast, PSYCHOLOGIST
- Clinical Psychologist
- Ft. Wainwright, AK
National Provider Identifier
1912546516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 133381
- Practice address
- 3406 Alder Ave
Ft. Wainwright, AK 99783-0001 - Phone
- (907) 353-4126
- NPI assigned
- Dec 30, 2019
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 133381 | AK | Primary |
Addresses
Primary practice location
3406 Alder Ave
Ft. Wainwright, AK 99783-0001
Mailing address
708 Suncrest Dr
Fairbanks, AK 99712-2663
Phone (907) 353-4126
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 29, 2025 through May 29, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 133381 | AK | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1577664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600732800000",
"number": "1912546516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "708 SUNCREST DR",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997122663",
"telephone_number": "907-353-4126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3406 ALDER AVE",
"city": "FT. WAINWRIGHT",
"state": "AK",
"postal_code": "997830001",
"telephone_number": "907-353-4126"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAST",
"first_name": "KATRINA",
"middle_name": "ANNE",
"name_prefix": "Dr.",
"credential": "PSYCHOLOGIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-30",
"last_updated": "2020-09-22",
"certification_date": "2020-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AK",
"license": "133381",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ft. Wainwright, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.