Individual provider Active NPI

Ryan James Brimley

  • Clinical Social Worker
  • Honolulu, HI
National Provider Identifier
1467830752
Registry record updated Jun 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4235 Issued in HI
Practice address
1110 University Ave Ste 310
Honolulu, HI 96826-1508
Phone
(801) 735-8898
Fax
(866) 230-2579
NPI assigned
May 7, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4235 HI Primary

Addresses

Primary practice location

1110 University Ave Ste 310
Honolulu, HI 96826-1508

Mailing address

759 Alewa Dr
Honolulu, HI 96817-1534
Phone (801) 735-8898

Other identifiers 1

IdentifierTypeStateIssuer
823557MedicaidHI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191106002079 HI Practitioner - Clinical Social Worker 8426380718

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1314 S King St
Suite 1460
Honolulu, HI 96814-1948

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4235HIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Counseling Center, LLC Clinical CurrentSince Sep 5, 2019 Accepting new patients

Locations

1110 University Ave
Ste 310
Honolulu, HI 96826
Phone (801) 735-8898

1314 S King St
Ste 1460
Honolulu, HI 96814
Phone (808) 217-9527

970 N Kalaheo Ave
Ste 201
Kailua, HI 96734

Organizations & group practices 1

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": "1430956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591660800000",
    "number": "1467830752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "759 ALEWA DR",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968171534",
            "telephone_number": "801-735-8898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 UNIVERSITY AVE STE 310",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968261508",
            "telephone_number": "801-735-8898",
            "fax_number": "866-230-2579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIMLEY",
        "first_name": "RYAN",
        "middle_name": "JAMES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-07",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "4235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "823557",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.