Individual provider Active NPI

Doreen Gray Redford, LMT

  • Massage Therapist
  • Honolulu, HI
National Provider Identifier
1720207657
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
9992 Issued in HI
Practice address
1441 Kapiolani Blvd
813
Honolulu, HI 96814-4402
Phone
(808) 955-7246
Fax
(808) 955-7249
NPI assigned
Apr 25, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 9992 HI Primary

Addresses

Primary practice location

1441 Kapiolani Blvd
813
Honolulu, HI 96814-4402

Mailing address

98-288 Kaonohi St
#3004
Aiea, HI 96701-2366
Phone (808) 366-5007

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
9992HIMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Evaluation and Rehabilitation Center of Hawaii Massage Therapist 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.

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720207657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98-288 KAONOHI ST",
            "address_2": "#3004",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967012366",
            "telephone_number": "808-366-5007",
            "fax_number": "808-487-7854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 KAPIOLANI BLVD",
            "address_2": "813",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144402",
            "telephone_number": "808-955-7246",
            "fax_number": "808-955-7249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDFORD",
        "first_name": "DOREEN",
        "middle_name": "GRAY",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "HI",
            "license": "9992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.