Individual provider Active NPI

Elyse Midori Kanda Lee

  • Pharmacist
  • Kamuela, HI
National Provider Identifier
1184090599
Registry record updated Oct 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
3876 Issued in HI
Practice address
65-1271 Kawaihae Rd
Kamuela, HI 96743-7369
Phone
(808) 885-4418
NPI assigned
Aug 19, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 3876 HI Primary

Addresses

Primary practice location

65-1271 Kawaihae Rd
Kamuela, HI 96743-7369

Mailing address

65-1271 Kawaihae Rd
Kamuela, HI 96743-7369
Phone (808) 885-4418

Other practice location 1

56 Oneawa St
Kailua, HI 96734-2501
Phone (808) 263-9980

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
3876HIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Longs Drug Store California LLC PastSince Oct 9, 2022 Accepting new patients
Walgreen Co PastSince Apr 17, 2022 Accepting new patients
Walgreen Co Past Accepting new patients
Longs Drug Stores California LLC PastSince Oct 9, 2022 Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1439942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1184090599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65-1271 KAWAIHAE RD",
            "city": "KAMUELA",
            "state": "HI",
            "postal_code": "967437369",
            "telephone_number": "808-885-4418",
            "fax_number": "808-885-5854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65-1271 KAWAIHAE RD",
            "city": "KAMUELA",
            "state": "HI",
            "postal_code": "967437369",
            "telephone_number": "808-885-4418"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "56 Oneawa St",
            "address_purpose": "LOCATION",
            "city": "Kailua",
            "state": "HI",
            "postal_code": "967342501",
            "country_code": "US",
            "telephone_number": "808-263-9980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "ELYSE",
        "middle_name": "MIDORI KANDA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-19",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "HI",
            "license": "3876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kamuela, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; 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.