Nicole M Koranda, OTRL

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

992 Issued in HI

Practice address

64-957 Mamalahoa Hwy
Kamuela, HI 96743-8415

Phone

(808) 209-7934

Fax

(808) 883-6262

NPI assigned

Apr 27, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Nicole Willette Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Keiki Therapy LLC

  • Occupational Therapist
  • Kamuela, HI
  • NPI 1437645181

  Pediatrics

  NPD Authorized official
• Hawaiian Rehabilitation Services Inc

  • Rehabilitation Clinic/Center
  • Kailua Kona, HI
  • NPI 1518935162
  NPD

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1700843372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2765",
            "city": "KAMUELA",
            "state": "HI",
            "postal_code": "967432765",
            "telephone_number": "808-209-7934",
            "fax_number": "808-883-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64-957 MAMALAHOA HWY",
            "city": "KAMUELA",
            "state": "HI",
            "postal_code": "967438415",
            "telephone_number": "808-209-7934",
            "fax_number": "808-883-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORANDA",
        "first_name": "NICOLE",
        "middle_name": "M",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-27",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "HI",
            "license": "992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "735277",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "WILLETTE",
            "credential": "OTRL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michael W Kimball, M.D.
• Cheryl Knowles, LMT/RN
• David A. Knowles, PA-C
• Kohala Coast Urgent Care LLC
• Kona Center of Facial Surgery
• Victoria Korge, PSY.D.
• Koru Health and Beauty, LLC (Island DermNurse)
• Brian Seigo Kubo, DDS
• Stephanie Kuczynski
• Nataliya Kudryn

• Pediatric Occupational Therapist in Kamuela, HI
• Providers in Kamuela, HI by specialty
• Pediatric Occupational Therapist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.