Individual provider Active NPI

Jennifer Ayumi Tobis, APRN, FNP-C

  • Family Nurse Practitioner
  • Kahului, HI
National Provider Identifier
1003654849
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN-4665-0 Issued in HI
Practice address
270 Dairy Rd Ste 239
Kahului, HI 96732-2986
Phone
(808) 667-6161
NPI assigned
Jul 16, 2024
Last updated
Aug 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN-4665-0 HI Primary

Addresses

Primary practice location

270 Dairy Rd Ste 239
Kahului, HI 96732-2986

Mailing address

287 Aliiolani St
Makawao, HI 96768-8329
Phone (808) 500-2248

Other names 1

  • Jennifer Ayumi Johnston Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240927002062 HI Practitioner - Nurse Practitioner 4284165556 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN-4665-0HIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
RP Medical LLC CurrentSince Aug 14, 2024 Accepting new patients

Locations

270 Dairy Rd
Ste 239
Kahului, HI 96732

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1721088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1003654849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "287 ALIIOLANI ST",
            "city": "MAKAWAO",
            "state": "HI",
            "postal_code": "967688329",
            "telephone_number": "808-500-2248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 DAIRY RD STE 239",
            "city": "KAHULUI",
            "state": "HI",
            "postal_code": "967322986",
            "telephone_number": "808-667-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOBIS",
        "first_name": "JENNIFER",
        "middle_name": "AYUMI",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-16",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN-4665-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "JOHNSTON",
            "middle_name": "AYUMI",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kahului, HI

Sources for this page

Verify at the official NPI Registry.