Organization Active NPI

McGill Healthcare LLC

  • Nurse Practitioner
  • Koloa, HI
National Provider Identifier
1760120315
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
MCGILL HEALTHCARE LLC
Practice address
5418 Nakoa St
Koloa, HI 96756
Phone
(808) 743-7473
NPI assigned
May 24, 2022
Last updated
Jul 24, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Authorized official

Name
Mr. Dennis McGill, APRNNPI 1154863496
Title
President
Phone
(808) 743-7473

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU Primary
Family Nurse Practitioner 363LF0000X NU
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU

Addresses

Primary practice location

5418 Nakoa St
Koloa, HI 96756

Mailing address

5418 Nakoa St
PO Box 1436
Koloa, HI 96756
Phone (808) 742-9140

Other identifiers 1

IdentifierTypeStateIssuer
3010790OtherKYKENTUCKY BON

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL mcgillhealthcarellc.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230317000798 HI Part B Supplier - Clinic/Group Practice 1456725241 Receives reassigned benefits from 1 practitioner
Practice locations: Koloa, HI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1653350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1760120315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5418 NAKOA ST",
            "address_2": "PO BOX 1436",
            "city": "KOLOA",
            "state": "HI",
            "postal_code": "96756",
            "telephone_number": "808-742-9140",
            "fax_number": "808-207-3805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5418 NAKOA ST",
            "city": "KOLOA",
            "state": "HI",
            "postal_code": "96756",
            "telephone_number": "808-743-7473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCGILL HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-24",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "MCGILL",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-743-7473",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENTUCKY BON",
            "identifier": "3010790",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "mcgillhealthcarellc.com",
            "affiliation": "N",
            "address_1": "5418 Nakoa St",
            "city": "Koloa",
            "state": "HI",
            "country_code": "US",
            "postal_code": "96756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Koloa, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.