Individual provider Active NPI

Aviella Knovelrhea Moore

  • Prosthetist
  • Kihei, HI
National Provider Identifier
1497256051
Registry record updated Feb 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthetistTaxonomy code 224P00000X
License
BEO21072 Issued in HI
Practice address
2439 S Kihei Rd
Kihei, HI 96753-7283
Phone
(808) 357-3504
NPI assigned
Feb 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetist 224P00000X BEO21072 HI Primary

Addresses

Primary practice location

2439 S Kihei Rd
Kihei, HI 96753-7283

Mailing address

1215 S Kihei Rd
Kihei, HI 96753-5220
Phone (808) 357-3504

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

State licenses

LicenseStateTypeSpecialty
BEO21072HIMDProsthetist

NPI Registry JSON

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

{
    "created_epoch": "1519689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519689600000",
    "number": "1497256051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 S KIHEI RD",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967535220",
            "telephone_number": "808-357-3504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2439 S KIHEI RD",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967537283",
            "telephone_number": "808-357-3504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "AVIELLA",
        "middle_name": "KNOVELRHEA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-27",
        "last_updated": "2018-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "HI",
            "license": "BEO21072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kihei, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.

Verify at the official NPI Registry.