NPIMap

Organization Active NPI

Waimea Primary Care LLC

  • Primary Care Nurse Practitioner
  • Kamuela, HI
National Provider Identifier
1417528399
Registry record updated Oct 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
WAIMEA PRIMARY CARE LLC
Practice address
65-1298B Kawaihae Rd Ste 3
Kamuela, HI 96743-7342
Phone
(808) 731-5003
Fax
(808) 731-4330
NPI assigned
Jul 1, 2021
Last updated
Oct 12, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2025

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

Authorized official

Name
Carly Kaleo Correa, APRNNPI 1992206973
Title
Owner
Phone
(808) 756-0334

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine Physician 2083P0901X NU
Health Service Clinic/Center 261QH0100X NU
Primary Care Nurse Practitioner 363LP2300X NU Primary

Addresses

Primary practice location

65-1298B Kawaihae Rd Ste 3
Kamuela, HI 96743-7342

Mailing address

65-1298B Kawaihae Rd Ste 3
Kamuela, HI 96743-7342
Phone (808) 756-0334

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address records@direct.waimeaprimarycare.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211027000333 HI Part B Supplier - Clinic/Group Practice 3173929114 Receives reassigned benefits from 3 practitioners
Practice locations: Kamuela, HI

National Provider Directory

National Provider Directory

Locations

65-1298 Kawaihae Rd
Ste 3
Kamuela, HI 96743

65-1298B Kawaihae Rd
Ste 3
Kamuela, HI 96743
Phone (808) 731-5003

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1625097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760227200000",
    "number": "1417528399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65-1298B KAWAIHAE RD STE 3",
            "city": "KAMUELA",
            "state": "HI",
            "postal_code": "967437342",
            "telephone_number": "808-756-0334",
            "fax_number": "808-731-4330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65-1298B KAWAIHAE RD STE 3",
            "city": "KAMUELA",
            "state": "HI",
            "postal_code": "967437342",
            "telephone_number": "808-731-5003",
            "fax_number": "808-731-4330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAIMEA PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-01",
        "last_updated": "2025-10-12",
        "certification_date": "2025-10-12",
        "status": "A",
        "authorized_official_last_name": "CORREA",
        "authorized_official_first_name": "CARLY",
        "authorized_official_middle_name": "KALEO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-756-0334",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "records@direct.waimeaprimarycare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "65-1298B Kawaihae Rd Ste 3",
            "city": "Kamuela",
            "state": "HI",
            "country_code": "US",
            "postal_code": "967437342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kamuela, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2025; 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.