Individual provider Active NPI

Lauren Victoria Musselman, PT

  • Physical Therapist
  • Kihei, HI
National Provider Identifier
1427634781
Registry record updated Mar 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5232 Issued in HI
Practice address
411 Huku Lii PL Ste 101
Kihei, HI 96753-7062
Phone
(808) 298-4933
NPI assigned
Mar 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5232 HI Primary

Addresses

Primary practice location

411 Huku Lii PL Ste 101
Kihei, HI 96753-7062

Mailing address

411 Huku Lii PL Ste 101
Kihei, HI 96753-7062
Phone (808) 298-4933

Other practice location 1

1827 Wells St Ste 2
Wailuku, HI 96793-2370
Phone (808) 244-0077

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211103002233 HI Practitioner - Physical Therapist in Private Practice 3375931793 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5232HIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
South Shore Physical Therapy & Sportsmedicine, Inc CurrentSince Dec 1, 2021 Accepting new patients
South Shore Physical Therapy & Sportsmedicine, Inc Physical Therapist CurrentSince Dec 1, 2021 Accepting new patients

Locations

411 Huku Lii Pl
Ste 101
Kihei, HI 96753
Phone (808) 298-4933

40 Kupuohi St
Ste 105
Lahaina, HI 96761
Phone (808) 661-0077

40 Kupaoa St
#B201
Makawao, HI 96768
Phone (808) 298-4933

1827 Wells St
Ste 2
Wailuku, HI 96793
Phone (808) 244-0077

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1616025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648339200000",
    "number": "1427634781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 HUKU LII PL STE 101",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967537062",
            "telephone_number": "808-298-4933",
            "fax_number": "866-465-8155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 HUKU LII PL STE 101",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967537062",
            "telephone_number": "808-298-4933"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1827 Wells St Ste 2",
            "address_purpose": "LOCATION",
            "city": "Wailuku",
            "state": "HI",
            "postal_code": "967932370",
            "country_code": "US",
            "telephone_number": "808-244-0077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUSSELMAN",
        "first_name": "LAUREN",
        "middle_name": "VICTORIA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-18",
        "last_updated": "2022-03-27",
        "certification_date": "2022-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "5232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kihei, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2022; 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.