Wailuku Internal Medicine Clinic LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

WAILUKU INTERNAL MEDICINE CLINIC LLC

Practice address

1063 Lower Main St Ste C106
Wailuku, HI 96793-6035

Phone

(808) 242-6478

NPI assigned

Apr 2, 2024

Last updated

Jun 26, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Maria Charito Gonzales Termulo, MDNPI 1538212113

Title

Manager

Phone

(808) 269-3918

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Locations

Practitioners 2

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.

• Maria Charito G. Termulo, MD

  • Internal Medicine Physician
  • Wailuku, HI
  • NPI 1538212113
  Medicare reassignment NPD Authorized official
• Noel Icasas Termulo, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Wailuku, HI
  • NPI 1154342376
  NPD

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

{
    "created_epoch": "1712016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719360000000",
    "number": "1477305506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1063 LOWER MAIN ST STE C106",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967936035",
            "telephone_number": "808-242-6478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1063 LOWER MAIN ST STE C106",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967936035",
            "telephone_number": "808-242-6478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAILUKU INTERNAL MEDICINE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-02",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A",
        "authorized_official_last_name": "TERMULO",
        "authorized_official_first_name": "MARIA CHARITO",
        "authorized_official_middle_name": "GONZALES",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "808-269-3918",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eduardo G. Villasenor, MD
• Jhasmine Jedah Amo Viloria, RBT
• Julia Kahalelaukoa II H Wadsworth, FNP
• Wailuku Dental Group Inc
• Wailuku Dentists LLC (Hawaii Dental Wailuku)
• Jody-Lee Waiohu, AA
• Walgreen Co (Walgreens #15115)
• Walgreen Co. (Walgreens #12764)
• Walgreen Co. (Walgreens #12763)
• Christina Dona Walker, LMT

• Clinic/Center in Wailuku, HI
• Providers in Wailuku, HI by specialty
• Clinic/Center in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; 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.