NPIMap

Organization Active NPI

Waterfront Physical Therapy LLC

  • Physical Therapist
  • Honolulu, HI
National Provider Identifier
1235297151
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 1990 Issued in HI
Legal business name
WATERFRONT PHYSICAL THERAPY LLC
Practice address
1221 Kapiolani Blvd
6 G
Honolulu, HI 96814
Phone
(808) 593-4005
Fax
(808) 591-2625
NPI assigned
Dec 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Alyce L Kim
Title
Member Manager
Phone
(808) 593-4005

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT 1990 HI Primary

Addresses

Primary practice location

1221 Kapiolani Blvd
6 G
Honolulu, HI 96814

Mailing address

PO Box 15683
Honolulu, HI 96830-5683
Phone (808) 593-4005

Other identifiers 1

IdentifierTypeStateIssuer
0000232694OtherHIHMSA

National Provider Directory

National Provider Directory

Locations

1221 Kapiolani Blvd
Ste 6G
Honolulu, HI 96814
Phone (808) 591-8000

Practitioners & affiliated clinicians

Practitioners 9

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": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235297151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15683",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968305683",
            "telephone_number": "808-593-4005",
            "fax_number": "808-591-2625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 KAPIOLANI BLVD",
            "address_2": "6 G",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "96814",
            "telephone_number": "808-593-4005",
            "fax_number": "808-591-2625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERFRONT PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "ALYCE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "808-593-4005",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT 1990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "0000232694",
            "state": "HI"
        }
    ],
    "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 Aug 22, 2020; 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.