Individual provider Active NPI

Glenda Faye Tali, PHD, RN, APRN

  • Women's Health Nurse Practitioner
  • Honolulu, HI
National Provider Identifier
1417460635
Registry record updated Nov 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
1225 Issued in HI
Practice address
1345 S Beretania St Ste 101
Honolulu, HI 96814-1802
Phone
(808) 744-2543
Fax
(866) 451-4608
NPI assigned
Nov 9, 2017
Last updated
Nov 9, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 1225 HI Primary

Addresses

Primary practice location

1345 S Beretania St Ste 101
Honolulu, HI 96814-1802

Mailing address

1345 S Beretania St Ste 101
Honolulu, HI 96814-1802
Phone (808) 744-2543

Other names 1

  • Glenda Faye Goble, Moore, Norton Former name

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230802000537 HI Practitioner - Nurse Practitioner 1557722964 Reassigns benefits to 1 organization
Practice locations: Honolulu, HI

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Doctor of Philosophy, Registered Nurse

State licenses

LicenseStateTypeSpecialty
1225HIMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Wellness, LLC CurrentSince Jan 11, 2024 Accepting new patients
Mana Psychological Services Corp CurrentSince May 15, 2023 Accepting new patients

Locations

1600 Kapiolani Blvd
Ste 524
Honolulu, HI 96814
Phone (808) 203-3399

401 Kamakee St
Ste 417
Honolulu, HI 96814
Phone (808) 369-0796

Interoperability endpoints

  • Direct secure messaging: glenda.tali@244233555804164.direct.elationemr.com
  • Direct secure messaging: glenda.tali@571527853113348.direct.elationemr.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1510185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510185600000",
    "number": "1417460635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 S BERETANIA ST STE 101",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141802",
            "telephone_number": "808-744-2543",
            "fax_number": "866-451-4608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 S BERETANIA ST STE 101",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141802",
            "telephone_number": "808-744-2543",
            "fax_number": "866-451-4608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALI",
        "first_name": "GLENDA",
        "middle_name": "FAYE",
        "credential": "PHD, RN, APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-09",
        "last_updated": "2017-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "HI",
            "license": "1225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GLENDA",
            "last_name": "GOBLE, MOORE, NORTON",
            "middle_name": "FAYE",
            "credential": "NONE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.