Individual provider Active NPI

Nancy A. Fitzgerald, D.C.

  • Sports Physician Chiropractor
  • Kailua Kona, HI
National Provider Identifier
1447416656
Registry record updated Nov 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
1047 Issued in HI
Practice address
74-5615 Luhia St
Kailua Kona, HI 96740-3622
Phone
(808) 640-8464
NPI assigned
Aug 6, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 1047 HI Primary

Addresses

Primary practice location

74-5615 Luhia St
Kailua Kona, HI 96740-3622

Mailing address

74-5615 Luhia St
Kailua Kona, HI 96740-3622
Phone (808) 640-8464

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1047HIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Flow LLC Past Accepting new patients
Lyndonville Family Chiropractic, Inc. PastSince Sep 20, 2004 Accepting new patients

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": "1217980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290384000000",
    "number": "1447416656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74-5615 LUHIA ST",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967403622",
            "telephone_number": "808-640-8464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74-5615 LUHIA ST",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967403622",
            "telephone_number": "808-640-8464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "NANCY",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-06",
        "last_updated": "2010-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "HI",
            "license": "1047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua Kona, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2010; 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.