Active NPI
Samantha Henriques, MS, ATC, CSCS
- Athletic Trainer
- Kapaa, HI
National Provider Identifier
1043628837
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT-57
- Practice address
- 4695 Mailihuna Rd
Kapaa, HI 96746-2051 - Phone
- (808) 821-4401
- Fax
- (808) 821-4420
- NPI assigned
- Jul 24, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT-57 | HI | Primary |
Addresses
Primary practice location
4695 Mailihuna Rd
Kapaa, HI 96746-2051
Mailing address
5011 Malu Rd
Kapaa, HI 96746-1758
Phone (808) 821-4401
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT-57 | HI | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406160000000",
"number": "1043628837",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5011 MALU RD",
"city": "KAPAA",
"state": "HI",
"postal_code": "967461758",
"telephone_number": "808-821-4401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4695 MAILIHUNA RD",
"city": "KAPAA",
"state": "HI",
"postal_code": "967462051",
"telephone_number": "808-821-4401",
"fax_number": "808-821-4420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENRIQUES",
"first_name": "SAMANTHA",
"credential": "MS, ATC, CSCS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-24",
"last_updated": "2014-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "HI",
"license": "AT-57",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kapaa, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.