Jla Senior Footcare Hi LLC

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

PO190 Issued in HI

Legal business name

JLA SENIOR FOOTCARE HI LLC

Practice address

1888 Kalakaua Ave
Honolulu, HI 96815-1510

Phone

(808) 347-0432

NPI assigned

Jan 18, 2011

Organization subpart

No

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

Authorized official

Name

Anthony Innocenzi

Title

Owner

Phone

(330) 702-0978

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1295308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295308800000",
    "number": "1659676971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4870 S ASPEN CT",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444068469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1888 KALAKAUA AVE",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968151510",
            "telephone_number": "808-347-0432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JLA SENIOR FOOTCARE HI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-18",
        "last_updated": "2011-01-18",
        "status": "A",
        "authorized_official_last_name": "INNOCENZI",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-702-0978"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "HI",
            "license": "PO190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Foot Surgery Podiatrist in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Foot Surgery Podiatrist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2011; 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.