Individual provider Active NPI

James Eun Park, MASSAGE THERAPIST

  • Massage Therapist
  • Honolulu, HI
National Provider Identifier
1124880521
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MAT6448 Issued in HI
Practice address
7192 Kalanianaole Hwy Ste E206
Honolulu, HI 96825-1849
Phone
(808) 797-8094
NPI assigned
Jan 30, 2024
Last updated
Jan 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MAT6448 HI Primary

Addresses

Primary practice location

7192 Kalanianaole Hwy Ste E206
Honolulu, HI 96825-1849

Mailing address

2256 Seaview Ave # 2130
Honolulu, HI 96822-2484
Phone (808) 342-1056

Other practice location 1

4429 Malaai St Ste 101
Honolulu, HI 96818-3158
Phone (808) 321-7135

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
MAT6448HIMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cassandra Peterson, DC, LLC CurrentSince May 28, 2019 Accepting new patients

Locations

7192 Kalanianaole Hwy
Ste E206
Honolulu, HI 96825
Phone (808) 797-8094

4429 Malaai St
Ste 101
Honolulu, HI 96818
Phone (415) 637-9781

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, 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": "1706572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1124880521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2256 SEAVIEW AVE # 2130",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968222484",
            "telephone_number": "808-342-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7192 KALANIANAOLE HWY STE E206",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968251849",
            "telephone_number": "808-797-8094"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4429 Malaai St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968183158",
            "country_code": "US",
            "telephone_number": "808-321-7135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "JAMES",
        "middle_name": "EUN",
        "credential": "MASSAGE THERAPIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-30",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "HI",
            "license": "MAT6448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Jan 30, 2024; 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.