Active NPI
Luzvelinda M Wilson
- Nursing Home Administrator
- Ewa Beach, HI
National Provider Identifier
1316489552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Home Administrator
- License
- 1-160072
- Practice address
- 91-992 Papapuhi PL
Ewa Beach, HI 96706-4722 - Phone
- (808) 393-9301
- Fax
- (888) 958-4492
- NPI assigned
- Nov 4, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Home Administrator | 376G00000X | 1-160072 | HI | Primary |
Addresses
Primary practice location
91-992 Papapuhi PL
Ewa Beach, HI 96706-4722
Mailing address
91-992 Papapuhi PL
Ewa Beach, HI 96706-4722
Phone (808) 393-9301
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1-160072 | Other | HI | CCFFH LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-160072 | HI | MD | Nursing Home Administrator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478217600000",
"number": "1316489552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "91-992 PAPAPUHI PL",
"city": "EWA BEACH",
"state": "HI",
"postal_code": "967064722",
"telephone_number": "808-393-9301",
"fax_number": "888-958-4492"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "91-992 PAPAPUHI PL",
"city": "EWA BEACH",
"state": "HI",
"postal_code": "967064722",
"telephone_number": "808-393-9301",
"fax_number": "888-958-4492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "LUZVELINDA",
"middle_name": "M",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-04",
"last_updated": "2016-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "376G00000X",
"taxonomy_group": "",
"desc": "Nursing Home Administrator",
"state": "HI",
"license": "1-160072",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CCFFH LICENSE NUMBER",
"identifier": "1-160072",
"state": "HI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ewa Beach, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.