Organization Active NPI

Jon F Graham MD LLC

  • Ambulatory Surgical Clinic/Center
  • Honolulu, HI
National Provider Identifier
1386815603
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
JON F GRAHAM MD LLC
Practice address
1441 Kapiolani Blvd Ste 2020
Honolulu, HI 96814-4408
Phone
(808) 550-4939
Fax
(808) 550-2842
NPI assigned
Mar 14, 2008
Last updated
May 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Authorized official

Name
Jon F Graham, MDNPI 1700847084
Title
President
Phone
(808) 550-4939

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X NU Primary

Addresses

Primary practice location

1441 Kapiolani Blvd Ste 2020
Honolulu, HI 96814-4408

Mailing address

1380 Lusitana St Ste 502
Honolulu, HI 96813-2441
Phone (808) 550-4939

Other identifiers 1

IdentifierTypeStateIssuer
024320MedicaidHI

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

1380 Lusitana St
Ste 407
Honolulu, HI 96813
Phone (808) 523-8833

2065 Main St
Ste 112
Wailuku, HI 96793
Phone (808) 550-4939

Practitioners & affiliated clinicians

Practitioners 4

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": "1205452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715212800000",
    "number": "1386815603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 LUSITANA ST STE 502",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132441",
            "telephone_number": "808-550-4939",
            "fax_number": "808-550-2842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 KAPIOLANI BLVD STE 2020",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144408",
            "telephone_number": "808-550-4939",
            "fax_number": "808-550-2842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JON F GRAHAM MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-14",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-550-4939",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024320",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

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