Individual provider Active NPI

Timothy Hale Hendlin, DC

  • Chiropractor
  • Kailua Kona, HI
National Provider Identifier
1396960258
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
271 Issued in HI
Practice address
75166 Kalani Street
Suite 203 Hendlin Chiropractic Health Center
Kailua Kona, HI 96740
Phone
(808) 329-5155
Fax
(808) 329-2726
NPI assigned
Apr 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 271 HI Primary
Chiropractor 111N00000X 14391 CA

Addresses

Primary practice location

75166 Kalani Street
Suite 203 Hendlin Chiropractic Health Center
Kailua Kona, HI 96740

Mailing address

75166 Kalani Street
Suite 203 Hendlin Chiropractic Health Center
Kailua Kona, HI 96740
Phone (808) 329-5155

Other identifiers 1

IdentifierTypeStateIssuer
98889OtherHIHMSA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151211002289 HI Practitioner - Chiropractic 5496707259 Practice locations: Kailua Kona, HI

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
271HIMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396960258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75166 KALANI STREET",
            "address_2": "SUITE 203 HENDLIN CHIROPRACTIC HEALTH CENTER",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "96740",
            "telephone_number": "808-329-5155",
            "fax_number": "808-329-2726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75166 KALANI STREET",
            "address_2": "SUITE 203 HENDLIN CHIROPRACTIC HEALTH CENTER",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "96740",
            "telephone_number": "808-329-5155",
            "fax_number": "808-329-2726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDLIN",
        "first_name": "TIMOTHY",
        "middle_name": "HALE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "HI",
            "license": "271",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "14391",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "98889",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua Kona, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.