NPIMap

Organization Active NPI

Kahala Clinic LLC

  • Child & Adolescent Psychiatry Physician
  • Honolulu, HI
National Provider Identifier
1053666842
Registry record updated Jul 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
MD12987 Issued in HI
Legal business name
KAHALA CLINIC LLC
Practice address
4211 Waialae Ave
Suite 207
Honolulu, HI 96816-5319
Phone
(808) 542-7349
NPI assigned
Jul 17, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2012

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

Authorized official

Name
Jason Richard Keifer, M.D.
Title
Owner
Phone
(808) 542-7349

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0804X MD12987 HI Primary

Addresses

Primary practice location

4211 Waialae Ave
Suite 207
Honolulu, HI 96816-5319

Mailing address

4211 Waialae Ave
Suite 207
Honolulu, HI 96816-5319

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342483200000",
    "number": "1053666842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4211 WAIALAE AVE",
            "address_2": "SUITE 207",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968165319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 WAIALAE AVE",
            "address_2": "SUITE 207",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968165319",
            "telephone_number": "808-542-7349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAHALA CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-17",
        "last_updated": "2012-07-17",
        "status": "A",
        "authorized_official_last_name": "KEIFER",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-542-7349",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "HI",
            "license": "MD12987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2012; 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.