NPIMap

Organization Active NPI

South Shore Physical Therapy, LLC

  • Physical Therapist
  • Honolulu, HI
National Provider Identifier
1619023181
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SOUTH SHORE PHYSICAL THERAPY, LLC
Practice address
1221 Kapiolani Blvd
Suite 730
Honolulu, HI 96814-3503
Phone
(808) 596-2333
Fax
(808) 596-4545
NPI assigned
Jan 26, 2007
Last updated
Jun 21, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Joseph Yamry
Title
Administrator
Phone
(808) 596-2333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

1221 Kapiolani Blvd
Suite 730
Honolulu, HI 96814-3503

Mailing address

1221 Kapiolani Blvd
Suite 730
Honolulu, HI 96814-3503
Phone (808) 596-2333

Other identifiers 3

IdentifierTypeStateIssuer
611578900OtherHIOWCP
Z1683OtherHIMDX
0000256479OtherHIHMSA(BCBS) PIN

National Provider Directory

National Provider Directory

Locations

1221 Kapiolani Blvd
Ste 730
Honolulu, HI 96814
Phone (808) 386-5363

Practitioners & affiliated clinicians

Practitioners 5

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": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1619023181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 KAPIOLANI BLVD",
            "address_2": "SUITE 730",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968143503",
            "telephone_number": "808-596-2333",
            "fax_number": "808-596-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 KAPIOLANI BLVD",
            "address_2": "SUITE 730",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968143503",
            "telephone_number": "808-596-2333",
            "fax_number": "808-596-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SHORE PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "YAMRY",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "808-596-2333"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP",
            "identifier": "611578900",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDX",
            "identifier": "Z1683",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA(BCBS) PIN",
            "identifier": "0000256479",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.