Individual provider Active NPI

Ken Takebayashi, LMT

  • Massage Therapist
  • Honolulu, HI
National Provider Identifier
1093003246
Registry record updated Jul 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MAT-12302 Issued in HI
Practice address
725 Kapiolani Blvd Ste C202
Honolulu, HI 96813-6023
Phone
(808) 596-7200
NPI assigned
Jul 20, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MAT-12302 HI Primary

Addresses

Primary practice location

725 Kapiolani Blvd Ste C202
Honolulu, HI 96813-6023

Mailing address

3601 Alani Dr
Honolulu, HI 96822-1415
Phone (808) 741-2201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MAT-12302HIMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hawaii Physical Therapy, Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1311120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311120000000",
    "number": "1093003246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 ALANI DR",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968221415",
            "telephone_number": "808-741-2201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 KAPIOLANI BLVD STE C202",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968136023",
            "telephone_number": "808-596-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKEBAYASHI",
        "first_name": "KEN",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-20",
        "last_updated": "2011-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "HI",
            "license": "MAT-12302",
            "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 20, 2011; 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.