Active NPI
Kelly Jonas, MAT, LAT, ATC
- Athletic Trainer
- Honolulu, HI
National Provider Identifier
1417637430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT-425
- Practice address
- 1337 Lower Campus Rd
Honolulu, HI 96822-2352 - Phone
- (808) 306-2313
- NPI assigned
- Jul 24, 2023
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT-425 | HI | Primary |
Addresses
Primary practice location
1337 Lower Campus Rd
Honolulu, HI 96822-2352
Mailing address
91-221 Oea PL
Kapolei, HI 96707-2795
Phone (808) 306-2313
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT-425 | HI | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1690156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690156800000",
"number": "1417637430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "91-221 OEA PL",
"city": "KAPOLEI",
"state": "HI",
"postal_code": "967072795",
"telephone_number": "808-306-2313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1337 LOWER CAMPUS RD",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968222352",
"telephone_number": "808-306-2313"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONAS",
"first_name": "KELLY",
"credential": "MAT, LAT, ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-07-24",
"last_updated": "2023-07-24",
"certification_date": "2023-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "HI",
"license": "AT-425",
"primary": true
}
],
"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 Jul 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.