Carrie Ip, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD-23310-0 Issued in HI

Practice address

15-2866 Pahoa Village Rd BLDG F
Pahoa, HI 96778-7720

Phone

(808) 333-3600

NPI assigned

Jun 25, 2020

Last updated

Feb 6, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• West Hawaii Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Kailua Kona, HI
  • NPI 1952335630
  Medicare reassignment NPD
• West Hawaii Community Health Center, Inc.

  dba Hawaii Island Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Pahoa, HI
  • NPI 1861376907
  NPD

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

{
    "created_epoch": "1593043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1629694609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75-5751 KUAKINI HWY STE 203",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967401753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15-2866 PAHOA VILLAGE RD BLDG F",
            "city": "PAHOA",
            "state": "HI",
            "postal_code": "967787720",
            "telephone_number": "808-333-3600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1319 Punahou St # 741",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968261001",
            "country_code": "US",
            "telephone_number": "808-369-1234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IP",
        "first_name": "CARRIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-25",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "HI",
            "license": "MDR-7957",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "HI",
            "license": "MD-23310-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marianne Hooker, L.C.S.W.
• Angelina T.M Horner, PHD
• Bryan Houston, LCSW
• Kerry Hubbell, L.M.T.
• Carol Ann Iadeluca-Myrianthis, PT, PSYD
• Ivaz LLC
• J & W Tours and Taxi
• J & W Tours and Taxi
• Stephanie Joerke, L.M.T.
• Eredulin Vigilla Julian

• Pediatrics Physician in Pahoa, HI
• Providers in Pahoa, HI by specialty
• Pediatrics Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.