Individual provider Active NPI

Edythe L. Kim, P.T.

  • Physical Therapist
  • Hilo, HI
National Provider Identifier
1669598777
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 575 Issued in HI
Practice address
944 W Kawailani St
Hilo, HI 96720-3218
Phone
(808) 959-9151
Fax
(808) 959-6202
NPI assigned
Mar 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 575 HI Primary

Addresses

Primary practice location

944 W Kawailani St
Hilo, HI 96720-3218

Mailing address

944 W Kawailani St
Hilo, HI 96720-3218
Phone (808) 959-9151

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
PT 575HIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669598777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "944 W KAWAILANI ST",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967203218",
            "telephone_number": "808-959-9151",
            "fax_number": "808-959-6202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "944 W KAWAILANI ST",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967203218",
            "telephone_number": "808-959-9151",
            "fax_number": "808-959-6202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "EDYTHE",
        "middle_name": "L.",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT 575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilo, HI

Sources for this page

  • 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.