Individual provider Active NPI

Jobelle Velasquez Serapion

  • Pediatric Registered Nurse
  • Waianae, HI
National Provider Identifier
1194358804
Registry record updated Feb 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Registered NurseTaxonomy code 163WP0200X
License
88453 Issued in HI
Practice address
86-409B Halona Rd
Waianae, HI 96792-2807
Phone
(808) 398-4488
NPI assigned
Feb 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X 88453 HI Primary

Addresses

Primary practice location

86-409B Halona Rd
Waianae, HI 96792-2807

Mailing address

86-409B Halona Rd
Waianae, HI 96792-2807
Phone (808) 398-4488

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
88453HIMDPediatric Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1582156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582156800000",
    "number": "1194358804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86-409B HALONA RD",
            "city": "WAIANAE",
            "state": "HI",
            "postal_code": "967922807",
            "telephone_number": "808-398-4488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86-409B HALONA RD",
            "city": "WAIANAE",
            "state": "HI",
            "postal_code": "967922807",
            "telephone_number": "808-398-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERAPION",
        "first_name": "JOBELLE",
        "middle_name": "VELASQUEZ",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-20",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "HI",
            "license": "88453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waianae, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2020; 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.