Individual provider Active NPI

Terrie Johnson, PA

  • Physician Assistant
  • Lihue, HI
National Provider Identifier
1316017510
Registry record updated Sep 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
AMD-110 Issued in HI
Practice address
3-3420 Kuhio Hwy
Suite B
Lihue, HI 96766-1098
Phone
(808) 245-1524
Fax
(808) 246-1361
NPI assigned
Nov 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X AMD-110 HI Primary

Addresses

Primary practice location

3-3420 Kuhio Hwy
Suite B
Lihue, HI 96766-1098

Mailing address

3-3420 Kuhio Highway
Suite B
Lihue, HI 96766-1098
Phone (808) 245-1524

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
I20041215000368 HI Practitioner - Physician Assistant 2264499839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kauai Medical ClinicGroup PAC ID 5092628479, 147 clinicians

Practice addresses (Care Compare)

3-3420 Kuhio Hwy
Suite B
Lihue, HI 96766-1098
Phone (808) 245-1500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.39 of 100Reported as group
Quality
79.9
Promoting interoperability
99
Improvement activities
40
Cost
82.23

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
AMD-110HIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kauai Medical Clinic CurrentSince May 1, 1996 Accepting new patients
Kauai Medical Clinic CurrentSince May 1, 1996 Accepting new patients
Kapiolani Medical Center for Women & Children Past Accepting new patients

Locations

3-3420 Kuhio Hwy
Ste B
Lihue, HI 96766
Phone (808) 245-1500

3-3420 Kuhio Hwy
Ste B
Lihue, HI 96766
Phone (808) 245-1500

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284681600000",
    "number": "1316017510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3-3420 KUHIO HIGHWAY",
            "address_2": "SUITE B",
            "city": "LIHUE",
            "state": "HI",
            "postal_code": "967661098",
            "telephone_number": "808-245-1524",
            "fax_number": "808-246-1361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3-3420 KUHIO HWY",
            "address_2": "SUITE B",
            "city": "LIHUE",
            "state": "HI",
            "postal_code": "967661098",
            "telephone_number": "808-245-1524",
            "fax_number": "808-246-1361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TERRIE",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2010-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "HI",
            "license": "AMD-110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lihue, HI

Sources for this page

Verify at the official NPI Registry.