International Okinawan Karate Academy & Wellness

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Legal business name

INTERNATIONAL OKINAWAN KARATE ACADEMY & WELLNESS

Doing business as

Iokaw

Practice address

1121 W Bell Rd Ste 373
Phoenix, AZ 85023-3516

Phone

(888) 516-1966

NPI assigned

Jun 29, 2023

Last updated

Jun 29, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Wallace Clyde Andrews III, CHIEF INSTRUCTOR

Title

BHT/Facilitator/Wellness Coach

Phone

(480) 925-1393

Specialties & licenses 4

Addresses

Other names 1

• IOKAW Doing business as

Locations

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

{
    "created_epoch": "1687996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687996800000",
    "number": "1548947872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2902 W SWEETWATER AVE APT 1036",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850291390",
            "telephone_number": "888-516-1966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 W BELL RD STE 373",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850233516",
            "telephone_number": "888-516-1966"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6107 E Encanto St",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852055956",
            "country_code": "US",
            "telephone_number": "480-925-1393",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1501 E Baseline Rd",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852331297",
            "country_code": "US",
            "telephone_number": "480-925-1393",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "719 E Pepper Pl",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852038747",
            "country_code": "US",
            "telephone_number": "480-925-1393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INTERNATIONAL OKINAWAN KARATE ACADEMY & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-29",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A",
        "authorized_official_last_name": "ANDREWS",
        "authorized_official_first_name": "WALLACE",
        "authorized_official_middle_name": "CLYDE",
        "authorized_official_title_or_position": "BHT/FACILITATOR/WELLNESS COACH",
        "authorized_official_telephone_number": "480-925-1393",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "CHIEF INSTRUCTOR"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "226000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Recreational Therapist Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IOKAW",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; 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.