Organization Active NPI

Kona Cardiovascular Inc

  • Cardiovascular Disease Physician
  • Kailua Kona, HI
National Provider Identifier
1033762760
Registry record updated Sep 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
KONA CARDIOVASCULAR INC
Practice address
75-167 Hualalai Rd Ste 100
Kailua Kona, HI 96740-1714
Phone
(808) 331-8494
Fax
(808) 331-8377
NPI assigned
Jul 22, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2019

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

Authorized official

Name
April M Johnson
Title
Manager
Phone
(808) 331-8494

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

75-167 Hualalai Rd Ste 100
Kailua Kona, HI 96740-1714

Mailing address

75-167 Hualalai Rd Ste 100
Kailua Kona, HI 96740-1714
Phone (808) 854-1162

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190926003153 HI Part B Supplier - Clinic/Group Practice 3072843424 Receives reassigned benefits from 1 practitioner
Practice locations: Kailua Kona, HI

National Provider Directory

National Provider Directory

Locations

75-167 Hualalai Rd
Ste 100
Kailua Kona, HI 96740
Phone (808) 331-8494

Practitioners & affiliated clinicians

Practitioners 1

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": "1563753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568851200000",
    "number": "1033762760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75-167 HUALALAI RD STE 100",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967401714",
            "telephone_number": "808-854-1162",
            "fax_number": "808-331-8377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-167 HUALALAI RD STE 100",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967401714",
            "telephone_number": "808-331-8494",
            "fax_number": "808-331-8377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KONA CARDIOVASCULAR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-22",
        "last_updated": "2019-09-19",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "APRIL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "808-331-8494"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua Kona, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; 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.