Kevin Leon Watkins II, MAT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MAT-14629 Issued in HI

Practice address

2611 Lioholo PL
Kihei, HI 96753-7118

Phone

(808) 250-0104

NPI assigned

Jan 9, 2021

Last updated

Jan 9, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1610150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610150400000",
    "number": "1386232858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 LIOHOLO PL",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967537118",
            "telephone_number": "808-250-0104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2611 LIOHOLO PL",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967537118",
            "telephone_number": "808-250-0104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "KEVIN",
        "middle_name": "LEON",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "MAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-09",
        "last_updated": "2021-01-09",
        "certification_date": "2021-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "HI",
            "license": "MAT-14629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NOT APPLICABLE",
            "identifier": "11111111111",
            "state": "HI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "VIPmauimassage.com",
            "affiliation": "N",
            "endpointDescription": "Contact us through website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2611 Lioholo Pl",
            "city": "Kihei",
            "state": "HI",
            "country_code": "US",
            "postal_code": "967537118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Massage Therapist in Kihei, HI
• Providers in Kihei, HI by specialty
• Massage Therapist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2021; 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.