Individual provider Active NPI

Vergia Kemp-Blackmon

  • Social Worker
  • Pearl City, HI
National Provider Identifier
1124166251
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
860 Fourth St
Pearl City, HI 96782-3312
Phone
(808) 453-5950
Fax
(808) 453-5966
NPI assigned
Feb 1, 2007
Sex
Female
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
Social Worker 104100000X Primary

Addresses

Primary practice location

860 Fourth St
Pearl City, HI 96782-3312

Mailing address

1700 Lanakila Ave
Honolulu, HI 96817-2115
Phone (808) 832-3823

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

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124166251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 LANAKILA AVE",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968172115",
            "telephone_number": "808-832-3823",
            "fax_number": "808-832-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 FOURTH ST",
            "city": "PEARL CITY",
            "state": "HI",
            "postal_code": "967823312",
            "telephone_number": "808-453-5950",
            "fax_number": "808-453-5966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMP-BLACKMON",
        "first_name": "VERGIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearl City, 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.