Organization Active NPI

Bristol Rehab LLC

  • Physical Therapy Clinic/Center
  • Honolulu, HI
National Provider Identifier
1205377868
Registry record updated Mar 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
3534 Issued in HI
Legal business name
BRISTOL REHAB LLC
Practice address
2439 Kapiolani Blvd Apt 601
Honolulu, HI 96826-4657
Phone
(808) 800-1178
NPI assigned
Mar 16, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2017

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

Authorized official

Name
Dr. Ryan Bristol, P.T.NPI 1083969638
Title
Owner/Physical Therapist
Phone
(808) 800-1178

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 3534 HI Primary

Addresses

Primary practice location

2439 Kapiolani Blvd Apt 601
Honolulu, HI 96826-4657

Mailing address

2439 Kapiolani Blvd Apt 601
Honolulu, HI 96826-4657
Phone (808) 800-1178

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170504001759 HI Part B Supplier - Clinic/Group Practice 5193002921 Receives reassigned benefits from 1 practitioner
Practice locations: Honolulu, HI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1489622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489622400000",
    "number": "1205377868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2439 KAPIOLANI BLVD APT 601",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968264657",
            "telephone_number": "808-800-1178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2439 KAPIOLANI BLVD APT 601",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968264657",
            "telephone_number": "808-800-1178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRISTOL REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-16",
        "last_updated": "2017-03-16",
        "status": "A",
        "authorized_official_last_name": "BRISTOL",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "808-800-1178",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "HI",
            "license": "3534",
            "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 Mar 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.