NPIMap

Organization Active NPI

Enphysio LLC

  • Physical Therapist
  • Mililani, HI
National Provider Identifier
1205530011
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ENPHYSIO LLC
Practice address
94-181 Keaolani St
Mililani, HI 96789-1823
Phone
(509) 554-2209
NPI assigned
Mar 27, 2023
Last updated
Mar 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Authorized official

Name
Tanner CrassNPI 1811446792
Title
Owner
Phone
(509) 554-2209

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 Therapist 225100000X NU Primary

Addresses

Primary practice location

94-181 Keaolani St
Mililani, HI 96789-1823

Mailing address

94-181 Keaolani St
Mililani, HI 96789-1823
Phone (509) 554-2209

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230613002977 HI Part B Supplier - Clinic/Group Practice 1254798838 Receives reassigned benefits from 13 practitioners
Practice locations: Mililani, HI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679875200000",
    "number": "1205530011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94-181 KEAOLANI ST",
            "city": "MILILANI",
            "state": "HI",
            "postal_code": "967891823",
            "telephone_number": "509-554-2209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94-181 KEAOLANI ST",
            "city": "MILILANI",
            "state": "HI",
            "postal_code": "967891823",
            "telephone_number": "509-554-2209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENPHYSIO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A",
        "authorized_official_last_name": "CRASS",
        "authorized_official_first_name": "TANNER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-554-2209"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mililani, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; 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.