Individual provider Active NPI

Raymond Lee Levister, PH.D.

  • Psychologist
  • Honolulu, HI
National Provider Identifier
1447460340
Registry record updated Apr 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY-823 Issued in HI
Practice address
210 Ward Ave
#124
Honolulu, HI 96814-4008
Phone
(808) 489-5558
Fax
(808) 585-0379
NPI assigned
May 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY-823 HI Primary

Addresses

Primary practice location

210 Ward Ave
#124
Honolulu, HI 96814-4008

Mailing address

445 Seaside Ave
# 2518
Honolulu, HI 96815-2640
Phone (808) 489-5558

Other identifiers 2

IdentifierTypeStateIssuer
990339751-96813-B004OtherHITRICARE
0000246991OtherHIHMSA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110601000853 HI Practitioner - Psychologist Billing Independently 2769669688 Practice locations: Honolulu, HI

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302480000000",
    "number": "1447460340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 SEASIDE AVE",
            "address_2": "# 2518",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968152640",
            "telephone_number": "808-489-5558",
            "fax_number": "808-585-0379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 WARD AVE",
            "address_2": "#124",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144008",
            "telephone_number": "808-489-5558",
            "fax_number": "808-585-0379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVISTER",
        "first_name": "RAYMOND",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2011-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "HI",
            "license": "PSY-823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "990339751-96813-B004",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "0000246991",
            "state": "HI"
        }
    ],
    "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 Apr 11, 2011; 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.