Individual provider Active NPI

Nancy Ann Jeffers, M.D.

  • Internal Medicine Physician
  • Honolulu, HI
National Provider Identifier
1508192121
Registry record updated Oct 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD-20743 Issued in HI
Practice address
1150 S King St Ste 302
Honolulu, HI 96814-1951
Phone
(707) 245-6330
Fax
(707) 237-3685
NPI assigned
Nov 2, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD-20743 HI Primary

Addresses

Primary practice location

1150 S King St Ste 302
Honolulu, HI 96814-1951

Mailing address

1150 S King St Ste 302
Honolulu, HI 96814-1951
Phone (707) 245-6330

Other identifiers 1

IdentifierTypeStateIssuer
010C96039OtherMIBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201009001002 HI Practitioner - Internal Medicine 4082937230 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
53253CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
West Hawaii Community Health Center, Inc. CurrentSince Sep 8, 2020 Accepting new patients
West Hawaii Community Health Center, Inc. Current Accepting new patients
West Hawaii Community Health Center, Inc. CurrentSince Sep 8, 2020 Accepting new patients
West Hawaii Community Health Center, Inc. Internal Medicine Current Accepting new patients
Aloha Integrative Healthcare LLC PastSince Oct 27, 2019 Accepting new patients

Locations

1178 Kinoole St
Hilo, HI 96720
Phone (808) 961-4082

450 Kilauea Ave
Ste 105
Hilo, HI 96720
Phone (808) 961-4071

16-192 Pili Mua St
Keaau, HI 96749
Phone (808) 930-0040

15-2866 Pahoa Village Rd
Bldg C
Pahoa, HI 96778
Phone (808) 965-9711

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1257120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1508192121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 S KING ST STE 302",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141951",
            "telephone_number": "707-245-6330",
            "fax_number": "707-237-3685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 S KING ST STE 302",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141951",
            "telephone_number": "707-245-6330",
            "fax_number": "707-237-3685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERS",
        "first_name": "NANCY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-02",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "MD-20743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "010C96039",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.