Individual provider Active NPI

Dewayne Bettag

  • Cognitive & Behavioral Psychologist
  • Ewa Beach, HI
National Provider Identifier
1346697117
Registry record updated May 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
Practice address
91-1841 Fort Weaver Rd
Ewa Beach, HI 96706-1909
Phone
(808) 681-3500
NPI assigned
May 20, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X Primary
Family Psychologist 103TF0000X
Intellectual & Developmental Disabilities Psychologist 103TM1800X

Addresses

Primary practice location

91-1841 Fort Weaver Rd
Ewa Beach, HI 96706-1909

Mailing address

91-1841 Fort Weaver Rd
Ewa Beach, HI 96706-1909

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

NPI Registry JSON

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

{
    "created_epoch": "1463702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463702400000",
    "number": "1346697117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-1841 FORT WEAVER RD",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967061909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-1841 FORT WEAVER RD",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967061909",
            "telephone_number": "808-681-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETTAG",
        "first_name": "DEWAYNE",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-20",
        "last_updated": "2016-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 May 20, 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.

Verify at the official NPI Registry.