Pegasus Realm LLC

Primary specialty

Health & Wellness CoachTaxonomy code 171400000X

Legal business name

PEGASUS REALM LLC

Practice address

402 Opihikao PL
Honolulu, HI 96825-1131

Phone

(808) 763-0107

NPI assigned

Feb 15, 2024

Last updated

Feb 15, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Adam Grimm

Title

Founder

Phone

(808) 763-0107

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1707955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707955200000",
    "number": "1629833934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 OPIHIKAO PL",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968251131",
            "telephone_number": "808-763-0107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 OPIHIKAO PL",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968251131",
            "telephone_number": "808-763-0107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEGASUS REALM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-15",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A",
        "authorized_official_last_name": "GRIMM",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "808-763-0107",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Burnadette Pedro
• Don D Pedro, PSYD
• Patrick Paul Pedro, M.D.
• Garry Peers, MD
• Lita Gosoco Peeters, PT
• Jearld Peguese
• Alaia Sarania Peifer
• Jane J Pelkey, RN, MPHCDE
• Rebecca Allison Pell, NP
• Jonathan Buchanon Pellett, MD

• Health & Wellness Coach in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Health & Wellness Coach in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; 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.