Organization Active NPI

Angie Peters MPT LLC

  • Specialist
  • Kahului, HI
National Provider Identifier
1275964751
Registry record updated Oct 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
2575 Issued in HI
Legal business name
ANGIE PETERS MPT LLC
Practice address
135 S Wakea Ave
Unit 112
Kahului, HI 96732-1385
Phone
(808) 280-7711
Fax
(808) 442-0690
NPI assigned
Dec 9, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2019

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

Authorized official

Name
Mrs. Angela Marie Peters, MPTNPI 1093766610
Title
Physical Therapist
Phone
(808) 280-7711

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 2575 HI Primary

Addresses

Primary practice location

135 S Wakea Ave
Unit 112
Kahului, HI 96732-1385

Mailing address

PO Box 790826
Paia, HI 96779-0826
Phone (808) 280-7711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150225000192 HI Part B Supplier - Clinic/Group Practice 3577889245 Receives reassigned benefits from 4 practitioners
Practice locations: Kahului, HI

National Provider Directory

National Provider Directory

Locations

135 S Wakea Ave
Ste 113
Kahului, HI 96732

135 S Wakea Ave
Ste 112113
Kahului, HI 96732

Practitioners & affiliated clinicians

Practitioners 4

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": "1386547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572480000000",
    "number": "1275964751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 790826",
            "city": "PAIA",
            "state": "HI",
            "postal_code": "967790826",
            "telephone_number": "808-280-7711",
            "fax_number": "808-249-8650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 S WAKEA AVE",
            "address_2": "UNIT 112",
            "city": "KAHULUI",
            "state": "HI",
            "postal_code": "967321385",
            "telephone_number": "808-280-7711",
            "fax_number": "808-442-0690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGIE PETERS MPT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-09",
        "last_updated": "2019-10-31",
        "status": "A",
        "authorized_official_last_name": "PETERS",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "808-280-7711",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "HI",
            "license": "2575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kahului, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2019; 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.