Active NPI
Kailua Physical Therapy Clinic, Inc
- Specialist
- Kailua, HI
National Provider Identifier
1003004896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 662
- Legal business name
- KAILUA PHYSICAL THERAPY CLINIC, INC
- Practice address
- 155 Hamakua Dr
Suite B
Kailua, HI 96734-2849 - Phone
- (808) 261-8931
- Fax
- (808) 261-0301
- NPI assigned
- Oct 5, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Janet S. Barretta, L.P.T.
- Title
- Owner/President
- Phone
- (808) 261-8931
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 662 | HI | Primary |
Addresses
Primary practice location
155 Hamakua Dr
Suite B
Kailua, HI 96734-2849
Mailing address
155 Hamakua Dr
Suite B
Kailua, HI 96734-2849
Phone (808) 261-8931
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HKPT | Other | HI | MEDICARE ID |
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in HI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040611001044 | HI | Part B Supplier - Clinic/Group Practice | 0042293763 |
Receives reassigned benefits from 6 practitioners Practice locations: Kailua, HI |
National Provider Directory
National Provider Directory- Tax ID family
- Kailua Physical Therapy Clinic Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Physical Therapist
- Kailua, HI
- NPI 1992031330
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191542400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1191542400000",
"number": "1003004896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 HAMAKUA DR",
"address_2": "SUITE B",
"city": "KAILUA",
"state": "HI",
"postal_code": "967342849",
"telephone_number": "808-261-8931",
"fax_number": "808-261-0301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "155 HAMAKUA DR",
"address_2": "SUITE B",
"city": "KAILUA",
"state": "HI",
"postal_code": "967342849",
"telephone_number": "808-261-8931",
"fax_number": "808-261-0301"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KAILUA PHYSICAL THERAPY CLINIC, INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-10-05",
"last_updated": "2007-10-05",
"status": "A",
"authorized_official_last_name": "BARRETTA",
"authorized_official_first_name": "JANET",
"authorized_official_middle_name": "S.",
"authorized_official_title_or_position": "OWNER/PRESIDENT",
"authorized_official_telephone_number": "808-261-8931",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "L.P.T."
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": "HI",
"license": "662",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE ID",
"identifier": "HKPT",
"state": "HI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kailua, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2007; 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.