Active NPI
Shieralyn P. Bala
- Community Health Worker
- Waipahu, HI
National Provider Identifier
1609193085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- W04530192-01
- Practice address
- 94-945 Lumiloke St
Waipahu, HI 96797-3947 - Phone
- (808) 671-1351
- Fax
- (808) 671-1351
- NPI assigned
- Apr 26, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | W04530192-01 | HI | Primary |
Addresses
Primary practice location
94-945 Lumiloke St
Waipahu, HI 96797-3947
Mailing address
94-945 Lumiloke St
Waipahu, HI 96797-3947
Phone (808) 671-1351
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| W04530192-01 | Medicaid | HI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| W04530192-01 | HI | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1272240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1272240000000",
"number": "1609193085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "94-945 LUMILOKE ST",
"city": "WAIPAHU",
"state": "HI",
"postal_code": "967973947",
"telephone_number": "808-671-1351",
"fax_number": "808-671-1351"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "94-945 LUMILOKE ST",
"city": "WAIPAHU",
"state": "HI",
"postal_code": "967973947",
"telephone_number": "808-671-1351",
"fax_number": "808-671-1351"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALA",
"first_name": "SHIERALYN",
"middle_name": "P.",
"name_prefix": "Miss",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-04-26",
"last_updated": "2010-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "HI",
"license": "W04530192-01",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "W04530192-01",
"state": "HI"
}
],
"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 Apr 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.