Active NPI
Teodora Jim, LPN
- Licensed Practical Nurse
- Honolulu, HI
National Provider Identifier
1154985331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 7267
- Practice address
- 3440 Leahi Ave
Honolulu, HI 96815-4235 - Phone
- (808) 733-4999
- NPI assigned
- Apr 23, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 7267 | HI | Primary |
Addresses
Primary practice location
3440 Leahi Ave
Honolulu, HI 96815-4235
Mailing address
94-450 Mokuola St Ste 100
Waipahu, HI 96797-3388
Phone (808) 944-2882
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7267 | HI | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557705600000",
"number": "1154985331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "94-450 MOKUOLA ST STE 100",
"city": "WAIPAHU",
"state": "HI",
"postal_code": "967973388",
"telephone_number": "808-944-2882"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3440 LEAHI AVE",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968154235",
"telephone_number": "808-733-4999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JIM",
"first_name": "TEODORA",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-23",
"last_updated": "2019-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "HI",
"license": "7267",
"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 May 13, 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.