Individual provider Active NPI

Naomi Noelani Carreno, R. D.

  • Registered Dietitian
  • Wailuku, HI
National Provider Identifier
1316138852
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
RD-928923 Issued in HI
Practice address
55 Maui Lani Pkwy
Wailuku, HI 96793-2416
Phone
(808) 243-6000
NPI assigned
Aug 8, 2007
Last updated
Jun 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X RD-928923 HI Primary

Addresses

Primary practice location

55 Maui Lani Pkwy
Wailuku, HI 96793-2416

Mailing address

37 Lauie Dr
Kula, HI 96790-7200
Phone (808) 283-8859

Other practice location 1

37 Lauie Dr
Kula, HI 96790-7200
Phone (808) 283-8859

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110721000144 HI Practitioner - Registered Dietitian Or Nutrition Professional 0143498980 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RD-928923HIMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan Inc Current Accepting new patients
Kaiser Foundation Health Plan, Inc. CurrentSince Oct 21, 2024 Accepting new patients

Locations

711 Kapiolani Blvd
Honolulu, HI 96813
Phone (808) 432-5312

55 Maui Lani Pkwy
Wailuku, HI 96793
Phone (808) 243-6000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1316138852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 LAUIE DR",
            "city": "KULA",
            "state": "HI",
            "postal_code": "967907200",
            "telephone_number": "808-283-8859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 MAUI LANI PKWY",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932416",
            "telephone_number": "808-243-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "37 Lauie Dr",
            "address_purpose": "LOCATION",
            "city": "Kula",
            "state": "HI",
            "postal_code": "967907200",
            "country_code": "US",
            "telephone_number": "808-283-8859",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARRENO",
        "first_name": "NAOMI",
        "middle_name": "NOELANI",
        "name_prefix": "Ms.",
        "credential": "R. D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-08",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "HI",
            "license": "RD-928923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "55 Maui Lani Pkwy",
            "city": "Wailuku",
            "state": "HI",
            "country_code": "US",
            "postal_code": "967932416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wailuku, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; 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.