Individual provider Active NPI

Stacie Keliinoi, DPT

  • Physical Therapist
  • Waipahu, HI
National Provider Identifier
1093124042
Registry record updated Aug 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
41189 Issued in CA
Practice address
94-1060 Waiopae St
Waipahu, HI 96797-5319
Phone
(808) 391-7092
NPI assigned
Aug 4, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 41189 CA Primary

Addresses

Primary practice location

94-1060 Waiopae St
Waipahu, HI 96797-5319

Mailing address

94-1060 Waiopae St
Waipahu, HI 96797-5319
Phone (808) 391-7092

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
41189CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1407110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407110400000",
    "number": "1093124042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94-1060 WAIOPAE ST",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967975319",
            "telephone_number": "808-391-7092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94-1060 WAIOPAE ST",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967975319",
            "telephone_number": "808-391-7092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELIINOI",
        "first_name": "STACIE",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-04",
        "last_updated": "2014-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "41189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waipahu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2014; 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.