Individual provider Active NPI

Dianna M Difrenna, LMT

  • Massage Therapist
  • Wailuku, HI
National Provider Identifier
1194883124
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
2455 Issued in HI
Practice address
1129 Lower Main St
#205
Wailuku, HI 96793-2053
Phone
(808) 242-7111
Fax
(808) 242-1393
NPI assigned
Dec 4, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 2455 HI Primary

Addresses

Primary practice location

1129 Lower Main St
#205
Wailuku, HI 96793-2053

Mailing address

1129 Lower Main St
#205
Wailuku, HI 96793-2053
Phone (808) 242-7111

Other identifiers 3

IdentifierTypeStateIssuer
2455OtherHISTATE LICENSE
4299OtherHINCBTMB
9899OtherHIAMTA

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
2455HIMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194883124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 LOWER MAIN ST",
            "address_2": "#205",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932053",
            "telephone_number": "808-242-7111",
            "fax_number": "808-242-1393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 LOWER MAIN ST",
            "address_2": "#205",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932053",
            "telephone_number": "808-242-7111",
            "fax_number": "808-242-1393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIFRENNA",
        "first_name": "DIANNA",
        "middle_name": "M",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "HI",
            "license": "2455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2455",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCBTMB",
            "identifier": "4299",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMTA",
            "identifier": "9899",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wailuku, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.