NPIMap

Organization Active NPI

Sutter Health Pacific

  • Psychiatric Hospital
  • Ewa Beach, HI
National Provider Identifier
1477519908
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
33-H Issued in HI
Legal business name
SUTTER HEALTH PACIFIC
Practice address
91-2301 Fort Weaver Rd
Ewa Beach, HI 96706-3602
Phone
(808) 671-8511
Fax
(808) 677-2570
NPI assigned
Apr 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Mark R. Mitchell, PH.D.
Title
Chief Executive Officer
Phone
(808) 671-8511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X 33-H HI Primary

Addresses

Primary practice location

91-2301 Fort Weaver Rd
Ewa Beach, HI 96706-3602

Mailing address

91-2301 Fort Weaver Rd
Ewa Beach, HI 96706-3602
Phone (808) 671-8511

Other identifiers 2

IdentifierTypeStateIssuer
0006220245OtherHIAETNA
508129MedicaidHI

Other names 1

  • Kahi Mohala Hospital Doing business as

National Provider Directory

National Provider Directory

Locations

91-2301 Fort Weaver Rd
Ewa Beach, HI 96706
Phone (808) 671-8511

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1145836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1477519908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-2301 FORT WEAVER RD",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967063602",
            "telephone_number": "808-671-8511",
            "fax_number": "808-677-2570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-2301 FORT WEAVER RD",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967063602",
            "telephone_number": "808-671-8511",
            "fax_number": "808-677-2570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTTER HEALTH PACIFIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-24",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "808-671-8511",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "HI",
            "license": "33-H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0006220245",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "508129",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kahi Mohala Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ewa Beach, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.