Kelly Mari Wachi, M.D.

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

MD-13891 Issued in HI

Practice address

65-1230 Mamalahoa Hwy
Suite C21
Kamuela, HI 96743-8318

Phone

(808) 887-0033

Fax

(808) 887-0035

NPI assigned

Jun 19, 2007

Last updated

Oct 27, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256601600000",
    "number": "1386849438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65-1230 MAMALAHOA HWY",
            "address_2": "SUITE C21",
            "city": "KAMUELA",
            "state": "HI",
            "postal_code": "967438318",
            "telephone_number": "808-887-0033",
            "fax_number": "808-887-0035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65-1230 MAMALAHOA HWY",
            "address_2": "SUITE C21",
            "city": "KAMUELA",
            "state": "HI",
            "postal_code": "967438318",
            "telephone_number": "808-887-0033",
            "fax_number": "808-887-0035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WACHI",
        "first_name": "KELLY",
        "middle_name": "MARI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-19",
        "last_updated": "2009-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "MD-13891",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "HI",
            "license": "MD-13891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vein Clinics of Hawaii LLC
• Mark Ramil Villarin, M.D.
• Dana Alina Vinter, MD
• Sharon Vitousek, M.D.
• Stacy Vroman
• Jacy Lynn Waiau, LMT
• Waikoloa Medical Arts, Inc.
• Waimea Medical Associates LLP
• Waimea Pacific Enterprises, LLC (Lyn Lam, M.D.)
• Waimea Primary Care LLC

• Rheumatology Physician in Kamuela, HI
• Providers in Kamuela, HI by specialty
• Rheumatology Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.