NPIMap

Organization Active NPI

Core Wellness Hawaii LLC

  • Physical Therapy Clinic/Center
  • Hilo, HI
National Provider Identifier
1003348400
Registry record updated May 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
CORE WELLNESS HAWAII LLC
Practice address
69 Railroad Ave
Suite A4
Hilo, HI 96720-7509
Phone
(808) 987-1879
NPI assigned
Apr 3, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2017

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

Authorized official

Name
Mrs. Erin L Wagner, LMT, PTANPI 1245769538
Title
Member Manager
Phone
(808) 987-1879

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)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X HI Primary

Addresses

Primary practice location

69 Railroad Ave
Suite A4
Hilo, HI 96720-7509

Mailing address

25-3420 Pakelekia St
Hilo, HI 96720-1318
Phone (808) 987-1879

Other names 1

  • 80/20 Physical Therapy & Wellness Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170719000565 HI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6406126762 Receives reassigned benefits from 8 practitioners
Practice locations: Hilo, HI

National Provider Directory

National Provider Directory

Locations

69 Railroad Ave
Ste A4
Hilo, HI 96720
Phone (808) 339-7861

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494288000000",
    "number": "1003348400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25-3420 PAKELEKIA ST",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967201318",
            "telephone_number": "808-987-1879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 RAILROAD AVE",
            "address_2": "SUITE A4",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967207509",
            "telephone_number": "808-987-1879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORE WELLNESS HAWAII LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-03",
        "last_updated": "2017-05-09",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "ERIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "808-987-1879",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMT, PTA"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "HI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "80/20 Physical Therapy & Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hilo, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2017; 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.