Active NPI
Lisa Fong
- Pharmacist
- Honolulu, HI
National Provider Identifier
1104446384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH-3952
- Practice address
- 1620 N School St
Honolulu, HI 96817-1844 - Phone
- (808) 832-8265
- NPI assigned
- Apr 17, 2020
- Last updated
- Apr 17, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH-3952 | HI | Primary |
Addresses
Primary practice location
1620 N School St
Honolulu, HI 96817-1844
Mailing address
1173 21St Ave
Honolulu, HI 96816-4637
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | EnterpriseRx | Direct |
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 |
|---|---|---|---|
| PH-3952 | HI | MD | Pharmacist |
Practice roles
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1587081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1587081600000",
"number": "1104446384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1173 21ST AVE",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968164637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1620 N SCHOOL ST",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968171844",
"telephone_number": "808-832-8265"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONG",
"first_name": "LISA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-17",
"last_updated": "2020-04-17",
"certification_date": "2020-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "HI",
"license": "PH-3952",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "EnterpriseRx",
"affiliation": "N",
"endpointDescription": "Pharmacy Operating System",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Pharmacy Operating System",
"address_1": "1620 N School St",
"city": "Honolulu",
"state": "HI",
"country_code": "US",
"postal_code": "968171844",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Apr 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.