Individual provider Active NPI

Debra Welch-Martin

  • Mechanotherapist
  • Kailua Kona, HI
National Provider Identifier
1669924528
Registry record updated Oct 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
MechanotherapistTaxonomy code 172M00000X
License
MAT 1240 Issued in HI
Practice address
75-5870 Walua Rd Ste 101
Kailua Kona, HI 96740-1392
Phone
(808) 329-9553
NPI assigned
Oct 26, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mechanotherapist 172M00000X MAT 1240 HI Primary

Addresses

Primary practice location

75-5870 Walua Rd Ste 101
Kailua Kona, HI 96740-1392

Mailing address

PO Box 1011
Kailua Kona, HI 96745-1011
Phone (808) 325-6265

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
MAT 1240HIMDMechanotherapist

NPI Registry JSON

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

{
    "created_epoch": "1477440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477440000000",
    "number": "1669924528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1011",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967451011",
            "telephone_number": "808-325-6265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-5870 WALUA RD STE 101",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967401392",
            "telephone_number": "808-329-9553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELCH-MARTIN",
        "first_name": "DEBRA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-26",
        "last_updated": "2016-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": "HI",
            "license": "MAT 1240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua Kona, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2016; 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.