NPIMap

Organization Active NPI

Honolulu Psychiatric Services LLC

  • Adult Mental Health Clinic/Center
  • Honolulu, HI
National Provider Identifier
1396017497
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
MD-15998 Issued in HI
Legal business name
HONOLULU PSYCHIATRIC SERVICES LLC
Practice address
2228 Liliha St Ste 404
Honolulu, HI 96817-1654
Phone
(808) 388-4969
Fax
(808) 748-3017
NPI assigned
Feb 3, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Dr. Raymond Davidson, MDNPI 1790981884
Title
Owner
Phone
(808) 386-6851

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X MD-15998 HI Primary
Adult Mental Health Clinic/Center 261QM0850X MD159987 HI

Addresses

Primary practice location

2228 Liliha St Ste 404
Honolulu, HI 96817-1654

Mailing address

2228 Liliha St Ste 404
Honolulu, HI 96817-1654
Phone (808) 386-6851

Other practice location 1

305 Wailuku Dr Ste 6A
Hilo, HI 96720-2488
Phone (808) 388-4969

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120605000572 HI Part B Supplier - Clinic/Group Practice 4486818390 Receives reassigned benefits from 2 practitioners
Practice locations: Honolulu, HI

National Provider Directory

National Provider Directory
Tax ID family
Honolulu Psychiatric Sercies LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

305 Wailuku Dr
Ste 6A
Hilo, HI 96720
Phone (808) 388-4969

2228 Liliha St
Ste 404
Honolulu, HI 96817
Phone (808) 258-0462

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1328227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1396017497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2228 LILIHA ST STE 404",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968171654",
            "telephone_number": "808-386-6851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2228 LILIHA ST STE 404",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968171654",
            "telephone_number": "808-388-4969",
            "fax_number": "808-748-3017"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 Wailuku Dr Ste 6A",
            "address_purpose": "LOCATION",
            "city": "Hilo",
            "state": "HI",
            "postal_code": "967202488",
            "country_code": "US",
            "telephone_number": "808-388-4969",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HONOLULU PSYCHIATRIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-03",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-386-6851",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "HI",
            "license": "MD-15998",
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "HI",
            "license": "MD159987",
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.