Active NPI
Cheri Bantilan, RDN, CD
- Registered Dietitian
- Haiku, HI
National Provider Identifier
1346025616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86083659
- Practice address
- 44 Alekanekelo PL
Haiku, HI 96708-5321 - Phone
- (808) 489-5395
- NPI assigned
- Aug 25, 2023
- Last updated
- Oct 13, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DI61072548 | WA | |
| Registered Dietitian | 133V00000X | 86083659 | HI | Primary |
Addresses
Primary practice location
44 Alekanekelo PL
Haiku, HI 96708-5321
Mailing address
44 Alekanekelo PL
Haiku, HI 96708-5321
Other practice location 1
3215 W Bertona St
Seattle, WA 98199-1622
Phone (808) 489-5395
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in HI
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86083659 | HI | MD | Registered Dietitian |
| DI61072548 | WA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cheri Macie LLC | Dietitian, Registered | Current | Accepting new patients |
| Hui No Ke Ola Pono, Inc. | Current | Accepting new patients | |
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
| Marjorie Nolan Cohn LLC | Dietitian, Registered | Past | Accepting new patients |
Locations
95 Mahalani St
Rm 21
Wailuku, HI 96793
Phone (808) 244-4647
Organizations & group practices 4
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.
-
- General Practice Physician
- Wailuku, HI
- NPI 1881701357
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697155200000",
"number": "1346025616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44 ALEKANEKELO PL",
"city": "HAIKU",
"state": "HI",
"postal_code": "967085321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44 ALEKANEKELO PL",
"city": "HAIKU",
"state": "HI",
"postal_code": "967085321",
"telephone_number": "808-489-5395"
}
],
"practiceLocations": [
{
"address_1": "3215 W Bertona St",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "981991622",
"country_code": "US",
"telephone_number": "808-489-5395",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BANTILAN",
"first_name": "CHERI",
"credential": "RDN, CD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-08-25",
"last_updated": "2023-10-13",
"certification_date": "2023-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WA",
"license": "DI61072548",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "HI",
"license": "86083659",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Haiku, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2023; 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.