Individual provider Active NPI

McKenzie Treadaway

  • Registered Nurse
  • Waipahu, HI
National Provider Identifier
1699338459
Registry record updated Apr 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
89827 Issued in HI
Practice address
94-450 Mokuola St Ste 100
Waipahu, HI 96797-3388
Phone
(808) 944-2882
NPI assigned
Apr 17, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 89827 HI Primary

Addresses

Primary practice location

94-450 Mokuola St Ste 100
Waipahu, HI 96797-3388

Mailing address

1445 D Ave
West Columbia, SC 29169-6106

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
89827HIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1555459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555459200000",
    "number": "1699338459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 D AVE",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291696106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94-450 MOKUOLA ST STE 100",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967973388",
            "telephone_number": "808-944-2882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREADAWAY",
        "first_name": "MCKENZIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-17",
        "last_updated": "2019-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "HI",
            "license": "89827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waipahu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2019; 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.