Individual provider Active NPI

Shanda Brack, APRN

  • Family Nurse Practitioner
  • Waianae, HI
National Provider Identifier
1316024102
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN 2164 Issued in HI
Practice address
86-260 Farrington Hwy
Waianae, HI 96792-3128
Phone
(808) 697-3800
NPI assigned
Nov 1, 2006
Last updated
Mar 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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 2164 HI Primary

Addresses

Primary practice location

86-260 Farrington Hwy
Waianae, HI 96792-3128

Mailing address

86-260 Farrington Hwy
Waianae, HI 96792-3128
Phone (808) 697-3800

Other names 1

  • Shanda Magee Former name

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
I20161027000796 HI Practitioner - Nurse Practitioner 6507144474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

599 Farrington Hwy
Unit 100
Kapolei, HI 96707-2028
Phone (808) 697-3800

86-260 Farringtion Hwy
Waianae, HI 96792-3128
Phone (808) 697-3300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN 2164HIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Waianae District Comprehensive Health and Hospital Board, Inc CurrentSince Sep 16, 2016 Accepting new patients
Waianae District Comprehensive Health and Hospital Board, Incorporated CurrentSince Sep 16, 2016 Accepting new patients

Locations

599 Farrington Hwy
Bldg 1
Kapolei, HI 96707

86-260 Farrington Hwy
Waianae, HI 96792
Phone (808) 696-7081

Interoperability endpoints

  • Direct secure messaging: shanda.lewis.p1@direct.wcchc.nextgenshare.com

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1316024102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86-260 FARRINGTON HWY",
            "city": "WAIANAE",
            "state": "HI",
            "postal_code": "967923128",
            "telephone_number": "808-697-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86-260 FARRINGTON HWY",
            "city": "WAIANAE",
            "state": "HI",
            "postal_code": "967923128",
            "telephone_number": "808-697-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACK",
        "first_name": "SHANDA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN 2164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANDA",
            "last_name": "MAGEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waianae, HI

Sources for this page

Verify at the official NPI Registry.