Individual provider Active NPI

Avis S Kaneshiro, PT

  • Physical Therapist
  • Honolulu, HI
National Provider Identifier
1629235080
Registry record updated Mar 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT810 Issued in HI
Practice address
2228 Liliha Street
Ste 407
Honolulu, HI 96817-1654
Phone
(808) 255-1200
Fax
(808) 748-0110
NPI assigned
May 21, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 810 HI
Physical Therapist 225100000X PT810 HI Primary

Addresses

Primary practice location

2228 Liliha Street
Ste 407
Honolulu, HI 96817-1654

Mailing address

PO Box 3264
Honolulu, HI 96801-3264
Phone (808) 533-2275

Other identifiers 1

IdentifierTypeStateIssuer
BG546YOtherHIMEDICARE PTAN

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

State licenses

LicenseStateTypeSpecialty
PT 810HIMDPhysical Therapist
PT810HIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553817600000",
    "number": "1629235080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3264",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968013264",
            "telephone_number": "808-533-2275",
            "fax_number": "808-533-1275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2228 LILIHA STREET",
            "address_2": "STE 407",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968171654",
            "telephone_number": "808-255-1200",
            "fax_number": "808-748-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANESHIRO",
        "first_name": "AVIS",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-21",
        "last_updated": "2019-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT 810",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "BG546Y",
            "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 Mar 29, 2019; 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.