NPIMap

Organization Active NPI

Pacific Spine & Rehab

  • Physical Therapist
  • Kahului, HI
National Provider Identifier
1518326552
Registry record updated Feb 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTA-241 Issued in HI
Legal business name
PACIFIC SPINE & REHAB
Practice address
95 Lono Ave
Suite 105
Kahului, HI 96732-1610
Phone
(808) 250-1166
NPI assigned
Feb 18, 2016
Last updated
Feb 18, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2016

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

Authorized official

Name
Eric Wruck, DCNPI 1528195310
Title
Owner
Phone
(808) 250-1166

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTA-241 HI Primary
Rehabilitation Chiropractor 111NR0400X DC726 HI

Addresses

Primary practice location

95 Lono Ave
Suite 105
Kahului, HI 96732-1610

Mailing address

PO Box 1140
Makawao, HI 96768-1140
Phone (808) 250-1166

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1455753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455753600000",
    "number": "1518326552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1140",
            "city": "MAKAWAO",
            "state": "HI",
            "postal_code": "967681140",
            "telephone_number": "808-250-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 LONO AVE",
            "address_2": "SUITE 105",
            "city": "KAHULUI",
            "state": "HI",
            "postal_code": "967321610",
            "telephone_number": "808-250-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC SPINE & REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-18",
        "last_updated": "2016-02-18",
        "status": "A",
        "authorized_official_last_name": "WRUCK",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-250-1166",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PTA-241",
            "primary": true
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "HI",
            "license": "DC726",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kahului, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2016; 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.