Organization Active NPI

Jaco Rehab Kapolei, LLC

  • Physical Therapist
  • Kapolei, HI
National Provider Identifier
1013490747
Registry record updated Sep 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
JACO REHAB KAPOLEI, LLC
Practice address
599 Farrington Hwy Ste 206
Kapolei, HI 96707-2028
Phone
(808) 381-8947
Fax
(808) 591-2245
NPI assigned
Sep 9, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2018

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

Authorized official

Name
Mr. Jaco J. Van Delden, P.T.
Title
Owner
Phone
(808) 381-8947

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

599 Farrington Hwy Ste 206
Kapolei, HI 96707-2028

Mailing address

1401 S Beretania St Ste 550
Honolulu, HI 96814-1880
Phone (808) 381-8947

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1536451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536451200000",
    "number": "1013490747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S BERETANIA ST STE 550",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141880",
            "telephone_number": "808-381-8947",
            "fax_number": "808-591-2245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "599 FARRINGTON HWY STE 206",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967072028",
            "telephone_number": "808-381-8947",
            "fax_number": "808-591-2245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACO REHAB KAPOLEI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-09",
        "last_updated": "2018-09-09",
        "status": "A",
        "authorized_official_last_name": "VAN DELDEN",
        "authorized_official_first_name": "JACO",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-381-8947",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kapolei, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2018; 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.