Active NPI
Kaitlin Kodama, LMT
- Massage Therapist
- Waipahu, HI
National Provider Identifier
1174099816
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- LMT-12487
- Practice address
- 94-216 Farrington Hwy # a-102
Waipahu, HI 96797-1922 - Phone
- (808) 600-9148
- NPI assigned
- Oct 20, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | LMT-12487 | HI | Primary |
Addresses
Primary practice location
94-216 Farrington Hwy # a-102
Waipahu, HI 96797-1922
Mailing address
94-216 Farrington Hwy # a-102
Waipahu, HI 96797-1922
Phone (808) 600-9148
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LMT-12487 | Other | HI | LICENSE MASSAGE THERAPIST |
Other names 1
- Kaitlin Letreta
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 |
|---|---|---|---|
| LMT-12487 | HI | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539993600000",
"number": "1174099816",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "94-216 FARRINGTON HWY # A-102",
"city": "WAIPAHU",
"state": "HI",
"postal_code": "967971922",
"telephone_number": "808-600-9148"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "94-216 FARRINGTON HWY # A-102",
"city": "WAIPAHU",
"state": "HI",
"postal_code": "967971922",
"telephone_number": "808-600-9148"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KODAMA",
"first_name": "KAITLIN",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-10-20",
"last_updated": "2018-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "HI",
"license": "LMT-12487",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE MASSAGE THERAPIST",
"identifier": "LMT-12487",
"state": "HI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KAITLIN",
"last_name": "LETRETA",
"credential": "LMT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Waipahu, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.