Individual provider Active NPI

Domingo B. Gumpal

  • Clinical Social Worker
  • Kahului, HI
National Provider Identifier
1124154356
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1547 Issued in HI
Practice address
296 W Hawaii St
Kahului, HI 96732-2610
Phone
(808) 873-8802
NPI assigned
Feb 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1547 HI Primary

Addresses

Primary practice location

296 W Hawaii St
Kahului, HI 96732-2610

Mailing address

296 W Hawaii St
Kahului, HI 96732-2610

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

LicenseStateTypeSpecialty
1547HIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124154356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "296 W HAWAII ST",
            "city": "KAHULUI",
            "state": "HI",
            "postal_code": "967322610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "296 W HAWAII ST",
            "city": "KAHULUI",
            "state": "HI",
            "postal_code": "967322610",
            "telephone_number": "808-873-8802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUMPAL",
        "first_name": "DOMINGO",
        "middle_name": "B.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "1547",
            "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 Jul 8, 2007; 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.