Individual provider Active NPI

Kevin K.L Kishida, LMT

  • Specialist
  • Kaneohe, HI
National Provider Identifier
1649604596
Registry record updated Aug 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
12204 Issued in HI
Practice address
45-1144 Kamehameha Hwy Ste 200
Kaneohe, HI 96744-3226
Phone
(808) 236-1529
Fax
(808) 236-0844
NPI assigned
Aug 28, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 12204 HI Primary

Addresses

Primary practice location

45-1144 Kamehameha Hwy Ste 200
Kaneohe, HI 96744-3226

Mailing address

45-1144 Kamehameha Hwy Ste 200
Kaneohe, HI 96744-3226
Phone (808) 236-1529

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12204HIMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1377648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377648000000",
    "number": "1649604596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45-1144 KAMEHAMEHA HWY STE 200",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "967443226",
            "telephone_number": "808-236-1529",
            "fax_number": "808-236-0844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45-1144 KAMEHAMEHA HWY STE 200",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "967443226",
            "telephone_number": "808-236-1529",
            "fax_number": "808-236-0844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISHIDA",
        "first_name": "KEVIN",
        "middle_name": "K.L",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-28",
        "last_updated": "2013-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "HI",
            "license": "12204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kaneohe, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2013; 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.