NPIMap

Organization Active NPI

Community Clinic of Maui Inc

Doing business as Malama I Ke Ola Health Center

  • Community Health Clinic/Center
  • Lahaina, HI
National Provider Identifier
1053564526
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
COMMUNITY CLINIC OF MAUI INC
Doing business as
Malama I Ke Ola Health Center
Practice address
15 Ipu Aumakua LN
Lahaina, HI 96761
Phone
(808) 667-7598
Fax
(808) 667-7492
NPI assigned
Oct 28, 2008
Last updated
Apr 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Authorized official

Name
Betty Jane Ott
Title
Chief Executive Officer
Phone
(808) 872-4018

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X NU Primary

Addresses

Primary practice location

15 Ipu Aumakua LN
Lahaina, HI 96761

Mailing address

1881 Nani Street
Wailuku, HI 96793-1811
Phone (808) 667-7598

Other names 1

  • Malama I Ke Ola Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040219000740 HI Part B Supplier - Clinic/Group Practice 2466365440 Receives reassigned benefits from 32 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lahaina, HI; Wailuku, HI; Kihei, HI; Kahului, HI

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712880000000",
    "number": "1053564526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1881 NANI STREET",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967931811",
            "telephone_number": "808-667-7598",
            "fax_number": "808-667-7492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 IPU AUMAKUA LN",
            "city": "LAHAINA",
            "state": "HI",
            "postal_code": "96761",
            "telephone_number": "808-667-7598",
            "fax_number": "808-667-7492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CLINIC OF MAUI INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-28",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A",
        "authorized_official_last_name": "OTT",
        "authorized_official_first_name": "BETTY",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "808-872-4018"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Malama I Ke Ola Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Malama I Ke Ola Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lahaina, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; 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.