Healing Tides Primary Care LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

HEALING TIDES PRIMARY CARE LLC

Practice address

1110 Nuuanu Ave # A1-182
Honolulu, HI 96817-5119

Phone

(808) 271-2619

NPI assigned

Apr 9, 2020

Organization subpart

No

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

Authorized official

Name

Erin HuntNPI 1639514573

Title

Owner

Phone

(808) 271-2619

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Locations

Practitioners 2

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

• Erin L. Hunt, M.D.

  • Family Medicine Physician
  • Honolulu, HI
  • NPI 1639514573
  Medicare reassignment Care Compare group NPD Authorized official
• Shauna M Raboteau, DO

  • Family Medicine Physician
  • Tacoma, WA
  • NPI 1679979025

  HI

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1586390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586822400000",
    "number": "1225657307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 NUUANU AVE # A1-182",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968175119",
            "telephone_number": "808-271-2619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 NUUANU AVE # A1-182",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968175119",
            "telephone_number": "808-271-2619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALING TIDES PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-09",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A",
        "authorized_official_last_name": "HUNT",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-271-2619"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Family Medicine Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2020; 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.