Active NPI
Wyvitra Knox Stokes, PA-C
- Medical Physician Assistant
- Kailua, HI
National Provider Identifier
1710923438
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- AMD-263
- Practice address
- 642 Ulukahiki St
Suite 209
Kailua, HI 96734-4439 - Phone
- (808) 230-8500
- Fax
- (808) 230-8501
- NPI assigned
- Jun 21, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | AMD-263 | HI | Primary |
Addresses
Primary practice location
642 Ulukahiki St
Suite 209
Kailua, HI 96734-4439
Mailing address
642 Ulukahiki St
Suite 209
Kailua, HI 96734-4439
Phone (808) 230-8500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 57593801 | Medicaid | HI |
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AMD-263 | HI | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ehrman H. Eldridge Jr MD LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251676800000",
"number": "1710923438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "642 ULUKAHIKI ST",
"address_2": "SUITE 209",
"city": "KAILUA",
"state": "HI",
"postal_code": "967344439",
"telephone_number": "808-230-8500",
"fax_number": "808-230-8501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "642 ULUKAHIKI ST",
"address_2": "SUITE 209",
"city": "KAILUA",
"state": "HI",
"postal_code": "967344439",
"telephone_number": "808-230-8500",
"fax_number": "808-230-8501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOKES",
"first_name": "WYVITRA",
"middle_name": "KNOX",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-21",
"last_updated": "2009-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "HI",
"license": "AMD-263",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "57593801",
"state": "HI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kailua, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.