Doherty Chiropractic PC
Organization Active NPI Chiropractor · Kamuela, HI
NPI 1497048110 · NPPES record last updated Nov 2, 2017
Key facts
- NPI
- 1497048110
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 1038 (HI)
- Legal business name
- DOHERTY CHIROPRACTIC PC
- Practice address
- 65-1231 Opelo Rd Ste 3
Kamuela, HI 96743-8376 - Phone
- (808) 885-9300
- Fax
- (808) 885-9060
- NPI assigned
- May 27, 2011
- Organization subpart
- No
Authorized official
- Name
- Dr. Edward Doherty
- Title
- Owner
- Phone
- (808) 885-9300
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in HI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120522001319 | HI | Part B Supplier - Clinic/Group Practice | 3678563368 |
Receives reassigned benefits from 1 practitioner Practice locations: Kamuela, HI |
National Provider Directory
Locations
65-1231 Opelo Rd
Ste 3
Kamuela, HI 96743
Phone (808) 885-9300
65-1235 Opelo Rd
Ste A2
Kamuela, HI 96743
Phone (808) 885-9300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 1038 | HI | Yes |
Addresses
Primary practice location
65-1231 Opelo Rd Ste 3
Kamuela, HI 96743-8376
Mailing address
PO Box 6318
Kamuela, HI 96743-6318
Phone (808) 885-9300
Other providers in Kamuela, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 2, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.