Individual provider Active NPI

Scott Enomoto

  • Pharmacist
  • Honolulu, HI
National Provider Identifier
1124676341
Registry record updated Aug 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH-861 Issued in HI
Practice address
1330 Pali Hwy
Honolulu, HI 96813-2230
Phone
(808) 536-5542
NPI assigned
Aug 30, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH-861 HI Primary

Addresses

Primary practice location

1330 Pali Hwy
Honolulu, HI 96813-2230

Mailing address

4078 Keanu St
Honolulu, HI 96816-4210

Other practice location 1

1330 Pali Hwy
Honolulu, HI 96813-2230
Phone (808) 536-5542

Other identifiers 1

IdentifierTypeStateIssuer
1134162902OtherHINPI

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL Longs.store09228@cvscaremark.com
CONNECT URL Longs.store09228@cvscaremark.com

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
PH-861HIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1567123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567123200000",
    "number": "1124676341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4078 KEANU ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968164210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 PALI HWY",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132230",
            "telephone_number": "808-536-5542"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1330 Pali Hwy",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968132230",
            "country_code": "US",
            "telephone_number": "808-536-5542",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENOMOTO",
        "first_name": "SCOTT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-30",
        "last_updated": "2019-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "HI",
            "license": "PH-861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1134162902",
            "state": "HI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Longs.store09228@cvscaremark.com",
            "affiliation": "N",
            "address_1": "1330 Pali Hwy",
            "city": "Honolulu",
            "state": "HI",
            "country_code": "US",
            "postal_code": "968132230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Longs.store09228@cvscaremark.com",
            "affiliation": "N",
            "address_1": "1330 Pali Hwy",
            "city": "Honolulu",
            "state": "HI",
            "country_code": "US",
            "postal_code": "968132230",
            "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 Aug 30, 2019; 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.