Active NPI
Roxan Juna Lee Simon Manzano, RN
- Case Manager/Care Coordinator
- Waipahu, HI
National Provider Identifier
1710566484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 94-530 Koaleo St
Waipahu, HI 96797-1634 - Phone
- (808) 352-2652
- Fax
- (808) 517-4251
- NPI assigned
- Apr 7, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Wound Care Registered Nurse | 163WW0000X | 79319 | HI | |
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
94-530 Koaleo St
Waipahu, HI 96797-1634
Mailing address
94-530 Koaleo St
Waipahu, HI 96797-1634
Phone (808) 352-2652
Other names 1
- Ms. Roxan Juna Lee Simon Umayam
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Waipahu | Other |
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 79319 | HI | MD | Wound Care Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617753600000",
"number": "1710566484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "94-530 KOALEO ST",
"city": "WAIPAHU",
"state": "HI",
"postal_code": "967971634",
"telephone_number": "808-352-2652",
"fax_number": "808-517-4251"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "94-530 KOALEO ST",
"city": "WAIPAHU",
"state": "HI",
"postal_code": "967971634",
"telephone_number": "808-352-2652",
"fax_number": "808-517-4251"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANZANO",
"first_name": "ROXAN JUNA LEE",
"middle_name": "SIMON",
"name_prefix": "Mrs.",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-07",
"last_updated": "2021-04-07",
"certification_date": "2021-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "163WW0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, Wound Care",
"state": "HI",
"license": "79319",
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Waipahu",
"affiliation": "N",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "Waipahu",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Waipahu",
"address_1": "94-530 Koaleo St",
"city": "Waipahu",
"state": "HI",
"country_code": "US",
"postal_code": "967971634",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "ROXAN JUNA LEE",
"last_name": "UMAYAM",
"middle_name": "SIMON",
"prefix": "MS.",
"credential": "RN",
"code": "1",
"type": "Former Name"
}
]
}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 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.