Ned Ken Shimabukuro, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

795 Issued in HI

Practice address

16-590 Old Volcano Rd # a
Keaau, HI 96749-8100

Phone

(808) 966-7478

Fax

(808) 966-7479

NPI assigned

Mar 12, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Keaau Physical Therapy Inc.

  • Physical Therapy Clinic/Center
  • Keaau, HI
  • NPI 1992991715
  NPD (past) Authorized official

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639201924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16-590 OLD VOLCANO RD # A",
            "city": "KEAAU",
            "state": "HI",
            "postal_code": "967498100",
            "telephone_number": "808-966-7478",
            "fax_number": "808-966-7479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16-590 OLD VOLCANO RD # A",
            "city": "KEAAU",
            "state": "HI",
            "postal_code": "967498100",
            "telephone_number": "808-966-7478",
            "fax_number": "808-966-7479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIMABUKURO",
        "first_name": "NED",
        "middle_name": "KEN",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02588201",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alicia Renee Schillewaert
• Mark G Schultz, NURSE PRACTITIONER
• Katrina A Scott, LPN
• Courtney Sen
• Jacqueline Shea
• Gage Sigman
• Jody Brett Silber
• Nathan Slusarski, DDS
• Tifanee A Smart
• Paulina Smith

• Physical Therapist in Keaau, HI
• Providers in Keaau, HI by specialty
• Physical Therapist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.