Keltie J'Nai Clevenger

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

16210 Issued in HI

Practice address

4-820 Kuhio Hwy Ste C-3
Kapaa, HI 96746-1588

Phone

(808) 755-5751

NPI assigned

Nov 4, 2019

Last updated

Nov 4, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1572825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1053955914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1724",
            "city": "LIHUE",
            "state": "HI",
            "postal_code": "967665724",
            "telephone_number": "808-755-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4-820 KUHIO HWY STE C-3",
            "city": "KAPAA",
            "state": "HI",
            "postal_code": "967461588",
            "telephone_number": "808-755-5751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEVENGER",
        "first_name": "KELTIE",
        "middle_name": "J'NAI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-04",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "HI",
            "license": "16210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Kapa'a, HI
• Providers in Kapa'a, HI by specialty
• Massage Therapist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2019; 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.