NPIMap

Organization Active NPI

Ke Ola Kino Physical Therapy, LLC

Doing business as Ke Ola Kino Physical Therapy

  • Physical Therapist
  • Hilo, HI
National Provider Identifier
1093234759
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT3170 Issued in HI
Legal business name
KE OLA KINO PHYSICAL THERAPY, LLC
Doing business as
Ke Ola Kino Physical Therapy
Practice address
2064 Kilauea Ave
Hilo, HI 96720-5233
Phone
(808) 238-4199
NPI assigned
Sep 13, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Malia Pua Lokelani Tallett, PTNPI 1578892675
Title
Owner
Phone
(808) 238-4199

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 PT3170 HI Primary

Addresses

Primary practice location

2064 Kilauea Ave
Hilo, HI 96720-5233

Mailing address

2064 Kilauea Ave
Hilo, HI 96720-5233
Phone (808) 238-4199

Other names 1

  • Ke Ola Kino Physical Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180628001134 HI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4183970460 Receives reassigned benefits from 6 practitioners
Practice locations: Hilo, HI

National Provider Directory

National Provider Directory

Locations

2064 Kilauea Ave
Hilo, HI 96720
Phone (808) 339-7478

474 Laukapu St
Ste 2
Hilo, HI 96720
Phone (808) 339-7478

Practitioners & affiliated clinicians

Practitioners 8

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": "1505260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1093234759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2064 KILAUEA AVE",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967205233",
            "telephone_number": "808-238-4199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2064 KILAUEA AVE",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967205233",
            "telephone_number": "808-238-4199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KE OLA KINO PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "TALLETT",
        "authorized_official_first_name": "MALIA",
        "authorized_official_middle_name": "PUA LOKELANI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-238-4199",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT3170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ke Ola Kino Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hilo, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.