NPIMap

Organization Active NPI

Maui Mobile Physical Theray, LLC

  • Physical Therapist
  • Lahaina, HI
National Provider Identifier
1063921310
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2957 Issued in HI
Legal business name
MAUI MOBILE PHYSICAL THERAY, LLC
Practice address
1010 Front St
Lahaina, HI 96761-1673
Phone
(808) 463-9774
Fax
(888) 972-6936
NPI assigned
Sep 29, 2017
Last updated
Jun 20, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Authorized official

Name
Andrew StampNPI 1164656682
Title
Member
Phone
(808) 463-9774

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2957 HI Primary

Addresses

Primary practice location

1010 Front St
Lahaina, HI 96761-1673

Mailing address

PO Box 213
Lahaina, HI 96767-0213

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1506643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529452800000",
    "number": "1063921310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 213",
            "city": "LAHAINA",
            "state": "HI",
            "postal_code": "967670213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 FRONT ST",
            "city": "LAHAINA",
            "state": "HI",
            "postal_code": "967611673",
            "telephone_number": "808-463-9774",
            "fax_number": "888-972-6936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAUI MOBILE PHYSICAL THERAY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-29",
        "last_updated": "2018-06-20",
        "status": "A",
        "authorized_official_last_name": "STAMP",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "808-463-9774"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "2957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jun 20, 2018; 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.