NPIMap

Organization Active NPI

Community Clinic of Maui, Inc.

Doing business as Malama I Ke Ola Health Center

  • Multi-Specialty Clinic/Center
  • Wailuku, HI
National Provider Identifier
1437758190
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
COMMUNITY CLINIC OF MAUI, INC.
Doing business as
Malama I Ke Ola Health Center
Practice address
1881 Nani St
Wailuku, HI 96793-1811
Phone
(808) 871-7772
NPI assigned
Oct 22, 2020
Last updated
Oct 22, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY CLINIC OF MAUI, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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

Authorized official

Name
Betty Jane Ott
Title
Chief Executive Officer
Phone
(808) 872-4018

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

1881 Nani St
Wailuku, HI 96793-1811

Mailing address

1881 Nani St
Wailuku, HI 96793-1811
Phone (808) 871-7772

Other practice location 1

670 Waiale Rd Apt A
Wailuku, HI 96793-2376
Phone (808) 244-0220

Other practice location 2

15 Ipu Aumakua Ln
Lahaina, HI 96761-1193
Phone (808) 667-7598

Other names 1

  • Malama I Ke Ola Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Community Clinic of Mau8 organizations share this tax ID, including this one
Part of
Community Clinic of Mau

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1603324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603324800000",
    "number": "1437758190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1881 NANI ST",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967931811",
            "telephone_number": "808-871-7772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1881 NANI ST",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967931811",
            "telephone_number": "808-871-7772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "670 Waiale Rd Apt A",
            "address_purpose": "LOCATION",
            "city": "Wailuku",
            "state": "HI",
            "postal_code": "967932376",
            "country_code": "US",
            "telephone_number": "808-244-0220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15 Ipu Aumakua Ln",
            "address_purpose": "LOCATION",
            "city": "Lahaina",
            "state": "HI",
            "postal_code": "967611193",
            "country_code": "US",
            "telephone_number": "808-667-7598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COMMUNITY CLINIC OF MAUI, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY CLINIC OF MAUI, INC.",
        "enumeration_date": "2020-10-22",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-21",
        "status": "A",
        "authorized_official_last_name": "OTT",
        "authorized_official_first_name": "BETTY",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "808-872-4018"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Malama I Ke Ola Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wailuku, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.