NPIMap

Organization Active NPI

Community Clinic of Maui, Inc.

Doing business as Malama I Ke Ola Health Center

  • Clinic/Center
  • Wailuku, HI
National Provider Identifier
1689814055
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
COMMUNITY CLINIC OF MAUI, INC.
Doing business as
Malama I Ke Ola Health Center
Practice address
1881 Nani Street
Wailuku, HI 96793
Phone
(808) 873-6305
Fax
(808) 872-4029
NPI assigned
Feb 25, 2009
Last updated
Apr 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Authorized official

Name
Betty Jane Ott
Title
Chief Executive Officer
Phone
(808) 872-4018

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1881 Nani Street
Wailuku, HI 96793

Mailing address

1881 Nani Street
Wailuku, HI 96793-1811
Phone (808) 873-6305

Other names 1

  • Malama I Ke Ola Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Community Clinic of Maui Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1235520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712880000000",
    "number": "1689814055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1881 NANI STREET",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967931811",
            "telephone_number": "808-873-6305",
            "fax_number": "808-872-4029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1881 NANI STREET",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "96793",
            "telephone_number": "808-873-6305",
            "fax_number": "808-872-4029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CLINIC OF MAUI, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-25",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A",
        "authorized_official_last_name": "OTT",
        "authorized_official_first_name": "BETTY",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "808-872-4018"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Malama I Ke Ola Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Malama I Ke Ola Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wailuku, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; 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.