NPIMap

Organization Active NPI

Supreme Wellness

  • Acupuncturist
  • Honolulu, HI
National Provider Identifier
1205618113
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
Legal business name
SUPREME WELLNESS
Practice address
1001 Waimanu St # D
Honolulu, HI 96814-3411
Phone
(808) 294-2632
NPI assigned
Oct 16, 2023
Last updated
Oct 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Authorized official

Name
Shannyn MatsumotoNPI 1689386435
Title
Practitioner
Phone
(808) 294-2632

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
Acupuncturist 171100000X NU Primary

Addresses

Primary practice location

1001 Waimanu St # D
Honolulu, HI 96814-3411

Mailing address

665 Halekauwila St Apt 2004
Honolulu, HI 96813-5914

National Provider Directory

National Provider Directory

Locations

1001 Waimanu St
Ste D
Honolulu, HI 96814
Phone (808) 294-2632

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1697414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697500800000",
    "number": "1205618113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 HALEKAUWILA ST APT 2004",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968135914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 WAIMANU ST # D",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968143411",
            "telephone_number": "808-294-2632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPREME WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-16",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A",
        "authorized_official_last_name": "MATSUMOTO",
        "authorized_official_first_name": "SHANNYN",
        "authorized_official_title_or_position": "PRACTITIONER",
        "authorized_official_telephone_number": "808-294-2632"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NU",
            "license": null,
            "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 Oct 17, 2023; 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.