Jelsa Marticio Isidro, TRANSPORTATION

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Practice address

75-5915 Walua Rd
Kailua Kona, HI 96740-1375

Phone

(808) 936-6547

Fax

(808) 327-9462

NPI assigned

Sep 30, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1601424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1093322208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 207",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967450207",
            "telephone_number": "808-936-6547",
            "fax_number": "808-327-9462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-5915 WALUA RD",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967401375",
            "telephone_number": "808-936-6547",
            "fax_number": "808-327-9462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISIDRO",
        "first_name": "JELSA",
        "middle_name": "MARTICIO",
        "credential": "TRANSPORTATION",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-30",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EMAIL",
            "affiliation": "N",
            "endpointDescription": "EMAIL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "HOME ADDRESS",
            "address_1": "73-1295 Onaona Dr",
            "city": "Kailua Kona",
            "state": "HI",
            "country_code": "US",
            "postal_code": "967409180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Non-emergency Medical Transport (VAN) in Kailua Kona, HI
• Providers in Kailua Kona, HI by specialty
• Non-emergency Medical Transport (VAN) in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; 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.