Organization Active NPI

Wildbird Chiropractic & Wellness LLC

  • Chiropractor
  • Kailua, HI
National Provider Identifier
1154058717
Registry record updated May 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
WILDBIRD CHIROPRACTIC & WELLNESS LLC
Practice address
354 Uluniu St Ste 100
Kailua, HI 96734-2532
Phone
(808) 261-4040
Fax
(808) 744-2077
NPI assigned
Aug 4, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2023

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

Authorized official

Name
Robin Eddins, DCNPI 1689262495
Title
Owner
Phone
(818) 448-6906

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

354 Uluniu St Ste 100
Kailua, HI 96734-2532

Mailing address

407 Uluniu St Ste 311
Kailua, HI 96734-2544

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221118002366 HI Part B Supplier - Clinic/Group Practice 6406224609 Receives reassigned benefits from 4 practitioners
Practice locations: Kailua, HI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1659571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683590400000",
    "number": "1154058717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 ULUNIU ST STE 311",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967342544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "354 ULUNIU ST STE 100",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967342532",
            "telephone_number": "808-261-4040",
            "fax_number": "808-744-2077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILDBIRD CHIROPRACTIC & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-04",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A",
        "authorized_official_last_name": "EDDINS",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-448-6906",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.