NPIMap

Organization Active NPI

Lifestyle Medicine Center of Hawaii, LLC

  • Cardiac Rehabilitation Registered Nurse
  • Kailua Kona, HI
National Provider Identifier
1538740766
Registry record updated Apr 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiac Rehabilitation Registered NurseTaxonomy code 163WC3500X
Legal business name
LIFESTYLE MEDICINE CENTER OF HAWAII, LLC
Practice address
75-1027 Henry St Ste 110
Kailua Kona, HI 96740-3154
Phone
(808) 769-5225
Fax
(808) 769-5099
NPI assigned
Apr 19, 2021
Last updated
Apr 19, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2021

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

Authorized official

Name
April M Johnson
Title
Director
Phone
(808) 854-1162

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiac Rehabilitation Registered Nurse 163WC3500X NU Primary

Addresses

Primary practice location

75-1027 Henry St Ste 110
Kailua Kona, HI 96740-3154

Mailing address

75-1027 Henry St Ste 110
Kailua Kona, HI 96740-3154
Phone (808) 769-5225

National Provider Directory

National Provider Directory

Locations

75-1027 Henry St
Ste 110
Kailua Kona, HI 96740
Phone (808) 769-5225

Practitioners & affiliated clinicians

Practitioners 4

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": "1618790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618790400000",
    "number": "1538740766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75-1027 HENRY ST STE 110",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967403154",
            "telephone_number": "808-769-5225",
            "fax_number": "808-769-5099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-1027 HENRY ST STE 110",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967403154",
            "telephone_number": "808-769-5225",
            "fax_number": "808-769-5099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTYLE MEDICINE CENTER OF HAWAII, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-19",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "APRIL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "808-854-1162"
    },
    "taxonomies": [
        {
            "code": "163WC3500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Cardiac Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua Kona, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2021; 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.