Active NPI
Bonnie Jean Stevenson, LMT CST
- Massage Therapist
- Kapa'au, HI
National Provider Identifier
1093478315
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 5417MAT.
- Practice address
- 54-3823 Omachi Rd.
Kapaau, HI 96755 - Phone
- (808) 896-5225
- NPI assigned
- Oct 14, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 5417MAT. | HI | Primary |
Addresses
Primary practice location
54-3823 Omachi Rd.
Kapaau, HI 96755
Mailing address
PO Box 1193
Kapaau, HI 96755
Phone (808) 896-5225
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5417MAT. | HI | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1634169600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634169600000",
"number": "1093478315",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1193",
"city": "KAPAAU",
"state": "HI",
"postal_code": "96755",
"telephone_number": "808-896-5225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "54-3823 OMACHI RD.",
"city": "KAPAAU",
"state": "HI",
"postal_code": "96755",
"telephone_number": "808-896-5225"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEVENSON",
"first_name": "BONNIE",
"middle_name": "JEAN",
"credential": "LMT CST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-10-14",
"last_updated": "2021-10-14",
"certification_date": "2021-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "HI",
"license": "5417MAT.",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kapa'au, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.