Individual provider Active NPI

Tina Selmar-Etting

  • Physical Therapist
  • Kailua Kona, HI
National Provider Identifier
1326439878
Registry record updated Feb 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT4199 Issued in ME
Practice address
75-5699 Kopiko St
Kailua Kona, HI 96740-3651
Phone
(808) 329-7744
NPI assigned
Feb 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT4199 ME Primary

Addresses

Primary practice location

75-5699 Kopiko St
Kailua Kona, HI 96740-3651

Mailing address

75-5699 Kopiko St
Kailua Kona, HI 96740-3651
Phone (808) 329-7744

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT4199MEMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1423094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423094400000",
    "number": "1326439878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75-5699 KOPIKO ST",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967403651",
            "telephone_number": "808-329-7744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-5699 KOPIKO ST",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967403651",
            "telephone_number": "808-329-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELMAR-ETTING",
        "first_name": "TINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-05",
        "last_updated": "2015-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT4199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua Kona, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.