Jaco Van Delden Physical Rehabilitation LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-1582 Issued in HI

Legal business name

JACO VAN DELDEN PHYSICAL REHABILITATION LLC

Practice address

1401 S Beretania St Ste 550
Honolulu, HI 96814-1880

Phone

(808) 381-8947

Fax

(808) 591-2245

NPI assigned

Sep 22, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Jaco J Van Delden, P.T.

Title

Owner

Phone

(808) 381-8947

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stacey Noelle Calvert, P.T.

  • Physical Therapist
  • Honolulu, HI
  • NPI 1225170020
  NPD (past)
• Shane E Hamman, P.T.

  • Physical Therapist
  • Honolulu, HI
  • NPI 1558666925
  NPD (past)
• Casey M Kozuma, P.T.

  • Physical Therapist
  • Honolulu, HI
  • NPI 1780723882
  NPD (past)
• Lindsay A,. Olmstead, P.T.

  • Physical Therapist
  • Honolulu, HI
  • NPI 1740548288
  NPD (past)
• Sarah H Stuhr, P.T.

  • Physical Therapist
  • Oregon City, OR
  • NPI 1851604045
  NPD (past)

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

{
    "created_epoch": "1253577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573084800000",
    "number": "1063746196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S BERETANIA ST STE 550",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141880",
            "telephone_number": "808-381-8947",
            "fax_number": "808-591-2245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S BERETANIA ST STE 550",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141880",
            "telephone_number": "808-381-8947",
            "fax_number": "808-591-2245"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "932 Ward Ave",
            "address_2": "7TH FLOOR",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968142131",
            "country_code": "US",
            "telephone_number": "808-381-8947",
            "fax_number": "808-396-6358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JACO VAN DELDEN PHYSICAL REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-22",
        "last_updated": "2019-11-07",
        "status": "A",
        "authorized_official_last_name": "VAN DELDEN",
        "authorized_official_first_name": "JACO",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-381-8947",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT-1582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "A20852-8",
            "state": "HI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "billing@jacorehab.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "HONOLULU",
            "address_1": "1401 S Beretania St Ste 550",
            "city": "Honolulu",
            "state": "HI",
            "country_code": "US",
            "postal_code": "968141880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kathryn Jackson
• Micheal Craig Jackson
• Mykeal Jackson, RBT
• William Lorenzo Jackson, M.D., PH.D.
• Jaco Rehab Honolulu Limited Partnership
• Andrew H Jacob, LMT
• Oli Jacobsen, MD
• Rachel Jacobson
• Richard Harvey Jacobson, MD
• Jacqueline S. Brown, DDS, Inc

• Physical Therapist in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Physical Therapist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.