NPIMap

Organization Active NPI

Community Clinic of Maui, Inc.

  • General Acute Care Hospital
  • Wailuku, HI
National Provider Identifier
1336993724
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
COMMUNITY CLINIC OF MAUI, INC.
Practice address
221 Mahalani St
Wailuku, HI 96793-2526
Phone
(808) 244-9056
NPI assigned
Apr 12, 2024
Last updated
Apr 12, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY CLINIC OF MAUI, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Authorized official

Name
John R Vaz, MDNPI 1952556201
Title
Chief Executive Officer
Phone
(808) 871-7772

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

221 Mahalani St
Wailuku, HI 96793-2526

Mailing address

1881 Nani St
Wailuku, HI 96793-1811
Phone (808) 871-7772

Other names 1

  • Maui Memorial Medical Center Other name

National Provider Directory

National Provider Directory
Tax ID family
Community Clinic of Mau8 organizations share this tax ID, including this one
Part of
Community Clinic of Mau

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1881 Nani St
Wailuku, HI 96793
Phone (808) 871-7772

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1712880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712880000000",
    "number": "1336993724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1881 NANI ST",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967931811",
            "telephone_number": "808-871-7772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 MAHALANI ST",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932526",
            "telephone_number": "808-244-9056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CLINIC OF MAUI, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY CLINIC OF MAUI, INC.",
        "enumeration_date": "2024-04-12",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A",
        "authorized_official_last_name": "VAZ",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "808-871-7772",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maui Memorial Medical Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Apr 12, 2024; 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.