Active NPI
Brenda A L Jackson, CNM
- Advanced Practice Midwife
- Kaneohe, HI
National Provider Identifier
1336295286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- APRN-89
- Practice address
- 45-602 Kamehameha Hwy
Kaneohe, HI 96744-2017 - Phone
- (808) 432-3800
- NPI assigned
- Jan 25, 2007
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | APRN-89 | HI | |
| Family Nurse Practitioner | 363LF0000X | APRN-89 | HI | |
| Advanced Practice Midwife | 367A00000X | APRN-89 | HI | Primary |
Addresses
Primary practice location
45-602 Kamehameha Hwy
Kaneohe, HI 96744-2017
Mailing address
45-602 Kamehameha Hwy
Kaneohe, HI 96744-2017
Phone (808) 432-3800
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 54134302 | Medicaid | HI | |
| 00A0229342 | Other | HI | HMSA BILLING NUMBER |
| 61565108 | Medicaid | HI |
Other names 1
- Brenda A Lewis
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
- Credentials
- Certified Nurse Midwife
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250812800000",
"number": "1336295286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45-602 KAMEHAMEHA HWY",
"city": "KANEOHE",
"state": "HI",
"postal_code": "967442017",
"telephone_number": "808-432-3800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45-602 KAMEHAMEHA HWY",
"city": "KANEOHE",
"state": "HI",
"postal_code": "967442017",
"telephone_number": "808-432-3800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "BRENDA",
"middle_name": "A L",
"credential": "CNM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-25",
"last_updated": "2009-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "HI",
"license": "APRN-89",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "HI",
"license": "APRN-89",
"primary": false
},
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "HI",
"license": "APRN-89",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "54134302",
"state": "HI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMSA BILLING NUMBER",
"identifier": "00A0229342",
"state": "HI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "61565108",
"state": "HI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "BRENDA",
"last_name": "LEWIS",
"middle_name": "A",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Kaneohe, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.