Active NPI
Sundara Amber Lotus Fitz-Gerald, LMFT
- Marriage & Family Therapist
- Kailua Kona, HI
National Provider Identifier
1114272002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LMFT- 464
- Practice address
- 75-5744 Alii Dr Ste 237
Kailua Kona, HI 96740-1740 - Phone
- (808) 329-5800
- NPI assigned
- Jul 17, 2012
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | LMFT- 464 | HI | Primary |
Addresses
Primary practice location
75-5744 Alii Dr Ste 237
Kailua Kona, HI 96740-1740
Mailing address
PO Box 2935
Kailua Kona, HI 96745-2935
Phone (808) 990-4605
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 |
|---|---|---|---|
| LMFT- 464 | HI | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr Ashley & Associates 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.
-
- Psychologist
- Kailua Kona, HI
- NPI 1629348206
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453852800000",
"number": "1114272002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2935",
"city": "KAILUA KONA",
"state": "HI",
"postal_code": "967452935",
"telephone_number": "808-990-4605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75-5744 ALII DR STE 237",
"city": "KAILUA KONA",
"state": "HI",
"postal_code": "967401740",
"telephone_number": "808-329-5800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZ-GERALD",
"first_name": "SUNDARA",
"middle_name": "AMBER LOTUS",
"name_prefix": "Mrs.",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-07-17",
"last_updated": "2016-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "HI",
"license": "LMFT- 464",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kailua Kona, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.