Active NPI
Pamela Kruse, MS
- Clinical Exercise Physiologist
- Kalaheo, HI
National Provider Identifier
1497220800
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Exercise Physiologist
- License
- 2298
- Practice address
- 4417 Ahopueo Dr
Kalaheo, HI 96741-9401 - Phone
- (808) 635-7497
- NPI assigned
- Oct 11, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Exercise Physiologist | 224Y00000X | 2298 | HI | Primary |
Addresses
Primary practice location
4417 Ahopueo Dr
Kalaheo, HI 96741-9401
Mailing address
4417 Ahopueo Dr
Kalaheo, HI 96741-9401
Phone (808) 635-7497
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2298 | HI | MD | Clinical Exercise Physiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539216000000",
"number": "1497220800",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4417 AHOPUEO DR",
"city": "KALAHEO",
"state": "HI",
"postal_code": "967419401",
"telephone_number": "808-635-7497"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4417 AHOPUEO DR",
"city": "KALAHEO",
"state": "HI",
"postal_code": "967419401",
"telephone_number": "808-635-7497"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRUSE",
"first_name": "PAMELA",
"credential": "MS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-10-11",
"last_updated": "2018-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "224Y00000X",
"taxonomy_group": "",
"desc": "Clinical Exercise Physiologist",
"state": "HI",
"license": "2298",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kalaheo, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.