NPIMap

Organization Active NPI

Elizabeth E Mannick MD a Professional Corporation

  • Pediatric Gastroenterology Physician
  • Kahului, HI
National Provider Identifier
1467611939
Registry record updated Jan 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
HI 13829 Issued in HI
Legal business name
ELIZABETH E MANNICK MD A PROFESSIONAL CORPORATION
Practice address
39 Kamehameha Ave
Suite B
Kahului, HI 96732-2263
Phone
(808) 877-2424
Fax
(808) 877-6464
NPI assigned
Jun 9, 2008
Last updated
Jan 26, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2009

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

Authorized official

Name
Dr. Elizabeth E MannickNPI 1306879747
Title
President
Phone
(808) 877-2424

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X HI 13829 HI
Pediatric Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0206X HI 13829 HI Primary

Addresses

Primary practice location

39 Kamehameha Ave
Suite B
Kahului, HI 96732-2263

Mailing address

1630B Piiholo Rd
Makawao, HI 96768-7244
Phone (808) 283-3330

Other identifiers 1

IdentifierTypeStateIssuer
1306879747OtherNPPES

National Provider Directory

National Provider Directory

Locations

39 W Kamehameha Ave
Ste B
Kahului, HI 96732
Phone (808) 877-2424

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232928000000",
    "number": "1467611939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630B PIIHOLO RD",
            "city": "MAKAWAO",
            "state": "HI",
            "postal_code": "967687244",
            "telephone_number": "808-283-3330",
            "fax_number": "808-877-6464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 KAMEHAMEHA AVE",
            "address_2": "SUITE B",
            "city": "KAHULUI",
            "state": "HI",
            "postal_code": "967322263",
            "telephone_number": "808-877-2424",
            "fax_number": "808-877-6464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH E MANNICK MD A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-09",
        "last_updated": "2009-01-26",
        "status": "A",
        "authorized_official_last_name": "MANNICK",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-877-2424",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "HI",
            "license": "HI 13829",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "HI",
            "license": "HI 13829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1306879747",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kahului, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2009; 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.