Active NPI
Victoria Mathis, APRN
- Gerontology Nurse Practitioner
- Kapa'a, HI
National Provider Identifier
1386964005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- APRN 933
- Practice address
- 1564B Wanaao Rd
Kapaa, HI 96746-2633 - Phone
- (808) 822-3829
- NPI assigned
- Jun 3, 2010
- Last updated
- Jun 3, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | APRN 933 | HI | Primary |
Addresses
Primary practice location
1564B Wanaao Rd
Kapaa, HI 96746-2633
Mailing address
1564B Wanaao Rd
Kapaa, HI 96746-2633
Phone (808) 822-3829
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN 933 | HI | MD | Gerontology Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1275523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1275523200000",
"number": "1386964005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1564B WANAAO RD",
"city": "KAPAA",
"state": "HI",
"postal_code": "967462633",
"telephone_number": "808-822-3829"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1564B WANAAO RD",
"city": "KAPAA",
"state": "HI",
"postal_code": "967462633",
"telephone_number": "808-822-3829"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHIS",
"first_name": "VICTORIA",
"name_prefix": "Mrs.",
"credential": "APRN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-06-03",
"last_updated": "2010-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "HI",
"license": "APRN 933",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kapa'a, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.