Active NPI
Kenneth A. Davis
- Independent Duty Medical Technicians
- Honolulu, HI
National Provider Identifier
1477692143
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Independent Duty Medical Technicians
- Practice address
- 400 Sand Island Pkwy
CGC Kukui (WLB-203)
Honolulu, HI 96819-4326 - Phone
- (808) 842-2860
- Fax
- (808) 842-2864
- NPI assigned
- Feb 6, 2007
- Last updated
- Nov 2, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Independent Duty Medical Technicians | 1710I1003X | NU | Primary |
Addresses
Primary practice location
400 Sand Island Pkwy
CGC Kukui (WLB-203)
Honolulu, HI 96819-4326
Mailing address
4200 Ocean St
Uscg Sector Jacksonville
Atlantic Beach, FL 32233
Phone (904) 564-7581
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351814400000",
"number": "1477692143",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4200 OCEAN ST",
"address_2": "USCG SECTOR JACKSONVILLE",
"city": "ATLANTIC BEACH",
"state": "FL",
"postal_code": "32233",
"telephone_number": "904-564-7581",
"fax_number": "904-564-7583"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 SAND ISLAND PKWY",
"address_2": "CGC KUKUI (WLB-203)",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968194326",
"telephone_number": "808-842-2860",
"fax_number": "808-842-2864"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "KENNETH",
"middle_name": "A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-06",
"last_updated": "2012-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "1710I1003X",
"taxonomy_group": "",
"desc": "Military Health Care Provider, Independent Duty Medical Technicians",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"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 Nov 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.