Active NPI
Frank Hollister, PAC
- Physician Assistant
- Wailuku, HI
National Provider Identifier
1568483873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- AMD2
- Practice address
- 2180 Main St
Wailuku, HI 96793-1666 - Phone
- (808) 242-6464
- Fax
- (808) 242-4209
- NPI assigned
- Jul 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | AMD2 | HI | Primary |
Addresses
Primary practice location
2180 Main St
Wailuku, HI 96793-1666
Mailing address
2180 Main Street
Wailuku, HI 96793
Phone (808) 242-6464
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 232405 | Other | HI | HMSA - 65CP |
| 55828103 | Medicaid | HI | |
| 232405 | Medicaid | HI | |
| 99017685996793B098 | Other | HI | TRICARE - CHAMPUS |
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)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207526400000",
"number": "1568483873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2180 MAIN STREET",
"city": "WAILUKU",
"state": "HI",
"postal_code": "96793",
"telephone_number": "808-242-6464",
"fax_number": "808-242-4209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2180 MAIN ST",
"city": "WAILUKU",
"state": "HI",
"postal_code": "967931666",
"telephone_number": "808-242-6464",
"fax_number": "808-242-4209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLISTER",
"first_name": "FRANK",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-21",
"last_updated": "2008-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "HI",
"license": "AMD2",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMSA - 65CP",
"identifier": "232405",
"state": "HI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "55828103",
"state": "HI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "232405",
"state": "HI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE - CHAMPUS",
"identifier": "99017685996793B098",
"state": "HI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wailuku, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.