Individual provider Active NPI

Iluminada Morin, CNA; PBT(ASCP)CM

  • Adult Care Home Facility
  • Waipahu, HI
National Provider Identifier
1538569348
Registry record updated Aug 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
HCBS 09- Issued in HI
Practice address
94-079 Waikele Loop
Waipahu, HI 96797-2641
Phone
(808) 686-9399
Fax
(888) 486-4191
NPI assigned
Aug 28, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X HCBS 09- HI Primary

Addresses

Primary practice location

94-079 Waikele Loop
Waipahu, HI 96797-2641

Mailing address

94-079 Waikele Loop
Waipahu, HI 96797-2641
Phone (808) 686-9399

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
HCBS 09-HIMDAdult Care Home Facility

NPI Registry JSON

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

{
    "created_epoch": "1409184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409184000000",
    "number": "1538569348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94-079 WAIKELE LOOP",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967972641",
            "telephone_number": "808-686-9399",
            "fax_number": "888-486-4191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94-079 WAIKELE LOOP",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967972641",
            "telephone_number": "808-686-9399",
            "fax_number": "888-486-4191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORIN",
        "first_name": "ILUMINADA",
        "credential": "CNA; PBT(ASCP)CM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-28",
        "last_updated": "2014-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "HI",
            "license": "HCBS 09-",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 28, 2014; 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.