Active NPI
South Shore Physical Therapy & Sportsmedicine, Inc
- Physical Therapy Clinic/Center
- Kihei, HI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Clinic/Center
- Legal business name
- SOUTH SHORE PHYSICAL THERAPY & SPORTSMEDICINE, INC
- Practice address
- 411 Huku Lii PL Ste 101
Kihei, HI 96753 - Phone
- (808) 298-4933
- Fax
- (808) 879-0177
- NPI assigned
- May 18, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Tiffany G Prangnell, P.T.
- Title
- Owner/Pres
- Phone
- (808) 879-0077
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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | Primary |
Addresses
Primary practice location
411 Huku Lii PL Ste 101
Kihei, HI 96753
Mailing address
411 Huku Lii PL,. Ste 101
Kihei, HI 96753
Phone (808) 879-0077
Other practice location 1
1827 Wells St Ste 2
Wailuku, HI 96793-2370
Phone (808) 244-0077
Other practice location 2
40 Kupuohi St Ste 105
Lahaina, HI 96761-2714
Phone (808) 661-0077
Other practice location 3
40 Kupaoa Street
B-201
Makawao, HI 96768
Phone (808) 879-0077
Other names 1
- Imua Physical Therapy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in HI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060810000214 | HI | Part B Supplier - Clinic/Group Practice | 5799788808 |
Receives reassigned benefits from 19 practitioners 5 other NPIs on this enrollment Practice locations: Kahului, HI; Kihei, HI; Lahaina, HI; Makawao, HI |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
- Physical Therapist
- Kahului, HI
- NPI 1396601647
5799788808
National Provider Directory
National Provider Directory- Tax ID family
- Imua Physical Therapy
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Physical Therapist
- Kahului, HI
- NPI 1396601647
Locations
118 Maa St
Kahului, HI 96732
Phone (808) 244-0077
411 Huku Lii Pl
Kihei, HI 96753
411 Huku Lii Pl
Ste 101
Kihei, HI 96753
Phone (808) 298-4933
3350 Lower Honoapiilani Rd
Ste 2
Lahaina, HI 96761
40 Kupaoa St
Ste B201
Makawao, HI 96768
40 Kupaoa St
#B201
Makawao, HI 96768
Phone (808) 298-4933
Practitioners & affiliated clinicians
Practitioners 32
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147910400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1602720000000",
"number": "1760435218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "411 HUKU LII PL,. STE 101",
"city": "KIHEI",
"state": "HI",
"postal_code": "96753",
"telephone_number": "808-879-0077",
"fax_number": "808-879-0177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 HUKU LII PL STE 101",
"city": "KIHEI",
"state": "HI",
"postal_code": "96753",
"telephone_number": "808-298-4933",
"fax_number": "808-879-0177"
}
],
"practiceLocations": [
{
"address_1": "1827 Wells St Ste 2",
"address_purpose": "LOCATION",
"city": "Wailuku",
"state": "HI",
"postal_code": "967932370",
"country_code": "US",
"telephone_number": "808-244-0077",
"fax_number": "808-244-0177",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "40 Kupuohi St Ste 105",
"address_purpose": "LOCATION",
"city": "Lahaina",
"state": "HI",
"postal_code": "967612714",
"country_code": "US",
"telephone_number": "808-661-0077",
"fax_number": "808-661-0177",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "40 Kupaoa Street",
"address_2": "B-201",
"address_purpose": "LOCATION",
"city": "Makawao",
"state": "HI",
"postal_code": "96768",
"country_code": "US",
"telephone_number": "808-879-0077",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "SOUTH SHORE PHYSICAL THERAPY & SPORTSMEDICINE, INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-18",
"last_updated": "2020-10-15",
"certification_date": "2020-10-15",
"status": "A",
"authorized_official_last_name": "PRANGNELL",
"authorized_official_first_name": "TIFFANY",
"authorized_official_middle_name": "G",
"authorized_official_title_or_position": "OWNER/PRES",
"authorized_official_telephone_number": "808-879-0077",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "P.T."
},
"taxonomies": [
{
"code": "261QP2000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Physical Therapy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Imua Physical Therapy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Kihei, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; 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.