Spark Matsunaga VA Medical Center

Primary specialty

VA Clinic/CenterTaxonomy code 261QV0200X

License

APRN-1831 Issued in HI

Legal business name

SPARK MATSUNAGA VA MEDICAL CENTER

Practice address

459 Patterson Road
Honolulu, HI 96819

Phone

(808) 748-1341

NPI assigned

Sep 16, 2015

Last updated

Sep 16, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Michael Jackson

Title

Administrative Officer

Phone

(808) 838-6509

Specialties & licenses 1

Addresses

Tax ID family

Spark M Matsunaga VA Medical Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• VA Pacific Island Health Care System

  • Family Nurse Practitioner
  • Tripler Army Medical Center, HI
  • NPI 1265822506
  NPD tax ID

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

{
    "created_epoch": "1442361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442361600000",
    "number": "1063881449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "459 PATTERSON ROAD",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "96819",
            "telephone_number": "808-748-1341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "459 PATTERSON ROAD",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "96819",
            "telephone_number": "808-748-1341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARK MATSUNAGA VA MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-16",
        "last_updated": "2015-09-16",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "808-838-6509",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QV0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, VA",
            "state": "HI",
            "license": "APRN-1831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Sozo, MFT
• Spa Hawaii You
• Ashleigh N Spalding
• Robert Matthew Spampata, RBT
• David Chase Spangler, PSYD
• Amber Spaulding, APRN, PMHNP-BC
• Storm Speakman, DO
• Kelsey Spear, APRN
• Elle Spears Spears
• Special Education Center of Hawaii

• VA Clinic/Center in Honolulu, HI
• Providers in Honolulu, HI by specialty
• VA Clinic/Center in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2015; 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.