Active NPI
David Crockett, LAC, LMT
- Acupuncturist
- Makawao, HI
National Provider Identifier
1215306485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 1057
- Practice address
- 78 Haele PL
Makawao, HI 96768-8054 - Phone
- (808) 298-6417
- NPI assigned
- Sep 17, 2015
- Last updated
- Sep 17, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 1057 | HI | Primary |
| Massage Therapist | 225700000X | 8484 | HI |
Addresses
Primary practice location
78 Haele PL
Makawao, HI 96768-8054
Mailing address
78 Haele PL
Makawao, HI 96768-8054
Phone (808) 298-6417
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
| License | State | Type | Specialty |
|---|---|---|---|
| 8484 | HI | MD | Internal Medicine Physician |
| 1057 | HI | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442448000000",
"number": "1215306485",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "78 HAELE PL",
"city": "MAKAWAO",
"state": "HI",
"postal_code": "967688054",
"telephone_number": "808-298-6417"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "78 HAELE PL",
"city": "MAKAWAO",
"state": "HI",
"postal_code": "967688054",
"telephone_number": "808-298-6417"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROCKETT",
"first_name": "DAVID",
"credential": "LAC, LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-09-17",
"last_updated": "2015-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "HI",
"license": "1057",
"primary": true
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "HI",
"license": "8484",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Makawao, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.