Individual provider Active NPI

Blaize Morningstar Pomeroy-Brawner, LMT

  • Massage Therapist
  • Pahoa, HI
National Provider Identifier
1528622701
Registry record updated Apr 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
14870 Issued in HI
Practice address
12-128 Mapuana Ave
Pahoa, HI 96778-7833
Phone
(808) 965-7422
NPI assigned
Apr 23, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 14870 HI Primary

Addresses

Primary practice location

12-128 Mapuana Ave
Pahoa, HI 96778-7833

Mailing address

12-128 Mapuana Ave
Pahoa, HI 96778-7833
Phone (808) 965-7422

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
14870HIMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1555977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555977600000",
    "number": "1528622701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12-128 MAPUANA AVE",
            "city": "PAHOA",
            "state": "HI",
            "postal_code": "967787833",
            "telephone_number": "808-965-7422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12-128 MAPUANA AVE",
            "city": "PAHOA",
            "state": "HI",
            "postal_code": "967787833",
            "telephone_number": "808-965-7422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POMEROY-BRAWNER",
        "first_name": "BLAIZE",
        "middle_name": "MORNINGSTAR",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-23",
        "last_updated": "2019-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "HI",
            "license": "14870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pahoa, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2019; 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.