Individual provider Active NPI

Tani Noelle Cromwell, SLP

  • Speech-Language Pathologist
  • Waipahu, HI
National Provider Identifier
1497232409
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP-2293 Issued in HI
Practice address
94-1181 Ka Uka Blvd Ste C
Waipahu, HI 96797-4485
Phone
(808) 260-9056
NPI assigned
Jul 23, 2018
Last updated
Jun 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP-2293 HI Primary

Addresses

Primary practice location

94-1181 Ka Uka Blvd Ste C
Waipahu, HI 96797-4485

Mailing address

94-1181 Ka Uka Blvd Ste C
Waipahu, HI 96797-4485
Phone (808) 260-9056

Other identifiers 1

IdentifierTypeStateIssuer
415559MedicaidAZ

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
SP-2293HIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sprouts Therapy LLC Speech-Language Pathologist CurrentSince Jun 16, 2024 Accepting new patients
Pioneer Pet, LLC PastSince Jun 12, 2019 Accepting new patients
BHSM Rehabilitation, LLC Past Accepting new patients
BHSM Rehabilitation, LLC PastSince Nov 19, 2019 Accepting new patients

Locations

1425 Keolu Dr
Kailua, HI 96734
Phone (808) 260-9056

94-1181 Ka Uka Blvd
Ste C
Waipahu, HI 96797

94-1181 Ka Uka Blvd
Ste C
Waipahu, HI 96797
Phone (808) 260-9056

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1532304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1497232409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94-1181 KA UKA BLVD STE C",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967974485",
            "telephone_number": "808-260-9056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94-1181 KA UKA BLVD STE C",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967974485",
            "telephone_number": "808-260-9056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROMWELL",
        "first_name": "TANI",
        "middle_name": "NOELLE",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-23",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "HI",
            "license": "SP-2293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "415559",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waipahu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; 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.