Active NPI
Larry E. Stevens
- Case Manager/Care Coordinator
- Hilo, HI
National Provider Identifier
1386779080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 1045 Kilauea Ave
Hilo, HI 96720-4201 - Phone
- (808) 974-4320
- Fax
- (808) 933-0533
- NPI assigned
- Feb 22, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | HI | Primary |
Addresses
Primary practice location
1045 Kilauea Ave
Hilo, HI 96720-4201
Mailing address
PO Box 1641
Pahoa, HI 96778-1641
Phone (808) 965-8696
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 539372-15 | Medicaid | HI |
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": "1172102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1386779080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1641",
"city": "PAHOA",
"state": "HI",
"postal_code": "967781641",
"telephone_number": "808-965-8696",
"fax_number": "808-933-0533"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1045 KILAUEA AVE",
"city": "HILO",
"state": "HI",
"postal_code": "967204201",
"telephone_number": "808-974-4320",
"fax_number": "808-933-0533"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEVENS",
"first_name": "LARRY",
"middle_name": "E.",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-22",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "HI",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "539372-15",
"state": "HI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hilo, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.