Individual provider Active NPI

Noel J Withers, APRN

  • Family Nurse Practitioner
  • Wailuku, HI
National Provider Identifier
1255768560
Registry record updated Oct 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN - 1585 Issued in HI
Practice address
95 Mahalani St
RM 21
Wailuku, HI 96793-2521
Phone
(808) 442-8656
NPI assigned
Oct 1, 2013
Last updated
Oct 1, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN - 1585 HI Primary

Addresses

Primary practice location

95 Mahalani St
RM 21
Wailuku, HI 96793-2521

Mailing address

95 Mahalani St
RM 21
Wailuku, HI 96793-2521
Phone (808) 442-8656

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140515001454 HI Practitioner - Nurse Practitioner 7315160538 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maui Memorial Emergency Medical Associates IncGroup PAC ID 7618224981, 23 clinicians

Practice addresses (Care Compare)

221 Mahalani St
Wailuku, HI 96793-2526
Phone (808) 244-9056

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN - 1585HIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Maui Memorial Emergency Medical Associates Inc CurrentSince Oct 1, 2018 Accepting new patients
Hui No Ke Ola Pono, Inc. CurrentSince Dec 29, 2013 Accepting new patients

Locations

221 Mahalani St
Wailuku, HI 96793
Phone (808) 242-2290

95 Mahalani St
Rm 21
Wailuku, HI 96793
Phone (808) 244-4647

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1380585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380585600000",
    "number": "1255768560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 MAHALANI ST",
            "address_2": "RM 21",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932521",
            "telephone_number": "808-442-8656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 MAHALANI ST",
            "address_2": "RM 21",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932521",
            "telephone_number": "808-442-8656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITHERS",
        "first_name": "NOEL",
        "middle_name": "J",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-10-01",
        "last_updated": "2013-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN - 1585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wailuku, HI

Sources for this page

Verify at the official NPI Registry.