Individual provider Active NPI

Valerie Roberts

  • Registered Dietitian
  • Honolulu, HI
National Provider Identifier
1104237270
Registry record updated Jul 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
72-LD Issued in HI
Practice address
3147 Kahiwa PL
Honolulu, HI 96822-1544
Phone
(808) 753-0145
Fax
(855) 509-0220
NPI assigned
May 12, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 72-LD HI Primary

Addresses

Primary practice location

3147 Kahiwa PL
Honolulu, HI 96822-1544

Mailing address

3147 Kahiwa PL
Honolulu, HI 96822-1544
Phone (808) 753-0145

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
72-LDHIMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Manoa Senior Living LLC CurrentSince Jul 17, 2022 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.

NPI Registry JSON

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

{
    "created_epoch": "1399852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656633600000",
    "number": "1104237270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3147 KAHIWA PL",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968221544",
            "telephone_number": "808-753-0145",
            "fax_number": "855-509-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3147 KAHIWA PL",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968221544",
            "telephone_number": "808-753-0145",
            "fax_number": "855-509-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "VALERIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-12",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "HI",
            "license": "72-LD",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.