Active NPI
Christy Lyn Bolibol Inda, M.S., R.D.
- Registered Dietitian
- Waimanalo, HI
National Provider Identifier
1245337716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 926865
- Practice address
- 41-1347 Kalanianaole Hwy
Waimanalo, HI 96795-1247 - Phone
- (808) 954-7103
- NPI assigned
- Sep 19, 2006
- Last updated
- Jan 7, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 926865 | HI | Primary |
Addresses
Primary practice location
41-1347 Kalanianaole Hwy
Waimanalo, HI 96795-1247
Mailing address
92-1519 Punawainui St
Kapolei, HI 96707-2829
Phone (808) 672-7246
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in HI
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 926865 | HI | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hui No Ke Ola Pono, Inc. | Current | Accepting new patients |
Locations
95 Mahalani St
Rm 19
Wailuku, HI 96793
95 Mahalani St
Rm 21
Wailuku, HI 96793
Phone (808) 244-4647
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Physician
- Wailuku, HI
- NPI 1881701357
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357516800000",
"number": "1245337716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "92-1519 PUNAWAINUI ST",
"city": "KAPOLEI",
"state": "HI",
"postal_code": "967072829",
"telephone_number": "808-672-7246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41-1347 KALANIANAOLE HWY",
"city": "WAIMANALO",
"state": "HI",
"postal_code": "967951247",
"telephone_number": "808-954-7103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INDA",
"first_name": "CHRISTY",
"middle_name": "LYN BOLIBOL",
"credential": "M.S., R.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-19",
"last_updated": "2013-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "HI",
"license": "926865",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Waimanalo, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2013; 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.