Active NPI
David Allen Davidson II, LMT
- Massage Therapist
- Kahului, HI
National Provider Identifier
1093537680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MAT-17792
- Practice address
- 95 Lono Ave Ste 105
Kahului, HI 96732-1610 - Phone
- (808) 873-0733
- Fax
- (808) 873-9646
- NPI assigned
- Oct 25, 2024
- Sex
- Male
- 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 | MAT-17792 | HI | Primary |
Addresses
Primary practice location
95 Lono Ave Ste 105
Kahului, HI 96732-1610
Mailing address
PO Box 1140
Makawao, HI 96768-1140
Phone (808) 873-0733
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 |
|---|---|---|---|
| MAT-17792 | HI | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacific Medical Group LLC | 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 and National Provider Directory roles.
-
- Adult Health Clinical Nurse Specialist
- Kahului, HI
- NPI 1811353998
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1729814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729814400000",
"number": "1093537680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1140",
"city": "MAKAWAO",
"state": "HI",
"postal_code": "967681140",
"telephone_number": "808-873-0733",
"fax_number": "808-873-9646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "95 LONO AVE STE 105",
"city": "KAHULUI",
"state": "HI",
"postal_code": "967321610",
"telephone_number": "808-873-0733",
"fax_number": "808-873-9646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIDSON",
"first_name": "DAVID",
"middle_name": "ALLEN",
"name_suffix": "II",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-10-25",
"last_updated": "2024-10-25",
"certification_date": "2024-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "HI",
"license": "MAT-17792",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kahului, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.